Transformation in self-identity amongst Taiwanese women in late pregnancy: A qualitative study

Background: In a culture transitioning between the traditions of old and modernity, the experience of pregnancy brings added challenges. Pregnant Taiwanese women in large cities are expected to modify their behavior in keeping with long-standing traditions that remain important to their families even if they themselves do not endorse the beliefs. To date, researchers have not examined the processes and the components of the transformation of self-identity during pregnancy under these cultural conditions. Objectives: To examine the transformation of self during pregnancy by women living in urban Taiwan at a time when modern ideas of women's roles and health care practices coexist with traditional cultural beliefs on these issues. Methods: This was a qualitative study using in-depth, open-ended interviews. Eighteen pregnant women receiving prenatal examinations at clinics located in a medical center in Taipei, Taiwan, participated in this study. Interview responses were analyzed using a phenomenological approach. Results: Cultural and family expectations clearly influenced women's activities and their sense of self during pregnancy. Two themes were central to these experiences. The first, "constructing a new self in the context of cultural values," reflected the need for women to develop a response to the traditional beliefs, taboos, and public advice made very explicit in their lives during pregnancy. The second theme, "building a new body image from the past self," addresses how women's reactions to the traditional beliefs and public advice influenced the ways in which the women viewed themselves as pregnant individuals. Conclusions: Cultural factors and body image issues shape the transformation of self-identity during pregnancy for women living in a modernizing, yet culturally traditional, urban environment in Taiwan. Awareness of the impact that such cultural influences have on the psycho-social experience of pregnancy will help health professionals to better understand and respect the process of self-identity involved in moving toward motherhood, and thereby to provide a woman-centered model of care that is also culturally sensitive. (C) 2009 Elsevier Ltd. All rights reserved.