possible pregnancy, or the point at which the unwed woman first noticed pregnancy symptoms and became concerned that she could be pregnant. Thirty of the 32 women reported symptoms such as a missed period, extreme thirst, strange food cravings, nausea, throwing up, sore breasts, and weight gain. They were “not feeling normal” (Kathleen, par. 1), and knew that “something was a little off” (Addy, par. 11). Jamie, a hair stylist from Washington, explained, “I guess like every girl, you just know your body and I knew something was definitely different” (par. 8).
Because early signs of pregnancy can vary from woman to woman, can go undetected even by a physician throughout her first trimester, and a pregnancy test is needed to confirm or rule out pregnancy (American Pregnancy Association, 2012), this stage was characterized by a great deal of uncertainty. Pregnancy was only a suspicion at this point and was one of many possible explanations for experienced symptoms. Cognizant of possible pregnancy, the unwed mothers briefly considered what this could mean for their life if their suspicions were confirmed. Their focus was less on the pregnancy itself, and more on the social consequences of being an unwed mother. Their greatest worry was the reaction of their parents. Lola explained, “I was most worried about telling my parents. I thought—is this going to destroy my relationship with them? I had a deep concern they would never forgive me and that this could be too big. I had shattered their hopes and dreams” (par. 7). Although unwed mothers may choose from a number
of strategies to manage their perceptions of possible pregnancy, behaviors cited in the narratives fell into one of two categories: denial or confirmation of pregnancy.
Denial of possible pregnancy. Five of the 32 unmarried mothers mentioned going into a state in denial after suspecting possible pregnancy. They attributed their symptoms to other possible explanations like traveling, being irregular, or just being tired or feeling stressed. They continued living life as normal both mentally and physically as if no symptoms had been
experienced, and “ignored it as long as possible” (Sonia, par. 2). They did not alter their clothes, lifestyle, or make any preparations to see a doctor or prepare for the baby—there was no need to because the reality of being pregnant was ignored. Describing her denial, Jane said, “I kept wanting to give it another day because maybe this isn’t real, ya know? I was thinkin’ maybe tomorrow, maybe tomorrow, maybe tomorrow…” (par. 11). Results suggest that a woman may remain in denial anywhere from a few weeks and a missed period to full term and in labor. The women in this study were not expecting to become pregnant, and some were unfamiliar with the symptoms of pregnancy, so it was easy for them to misinterpret the signs of pregnancy or simply ignore physical changes. Sonia, who remained in denial for almost her entire pregnancy, claimed that even when she met with the adoption counselors a few weeks before her delivery, she still was not convinced she was pregnant. Charlotte, who also put her baby up for adoption, said she did not cognitively register that she was pregnant until she went into labor.
Although the prevalence rate of denied pregnancy in this study is relatively low (15%), it suggests that denial of pregnancy is not rare. Some researchers have warned that the number of observed denial cases has increased over the years (Wessel et al., 2003). What can be particularly dangerous at this stage in the process, however, is if a pregnant woman remains in denial
Charlotte and Sonia. Studies have found that denied pregnancies typically lead to the mother receiving little or no prenatal care and not making the appropriate lifestyle choices for a pregnant woman, which are both important to the health and well-being of the infant and mother (Wessel et al., 2003).
Acknowledgment of possible pregnancy. The remaining 27 women began immediately taking steps to confirm or rule out their suspicion of pregnancy. The women recalled (a) looking up their symptoms on the Internet, (b) reflecting back on previous sexual encounters and
considering if preventatives could have failed or were not used, and (c) seeking advice from a best friend, sibling, or partner. However, the most common way they acknowledged their symptoms and managed their perceived pregnancy was to take an at-home pregnancy test.
Thirty of the 32 women reported taking an at-home test at some point during their pregnancy to determine pregnancy status. This is not surprising given that at-home tests are private, convenient, and cost effective—all characteristics that are important to a woman who fears letting others know about her pregnancy status. Reflecting back on their experiences, several women joked about the vast number of at-home pregnancy tests they took and the various brands they tried. Apparently, the positive result they received caused them to question the accuracy of the at-home test and their ability to follow directions and take the test correctly. Laughing, Evelyn said, “Honest to God, my friend turned the directions of the test over and started reading it top to bottom in Spanish to make sure we didn’t miss anything or do it wrong!” (par. 11).
Although the U.S. Department of Health and Human Services (2006) reports that most at- home tests are 97-99% accurate, the women also knew that the results are reliable only when used according to package instructions one week after a missed period (Harms & Wick, 2011).
These conditions provided a glimpse of hope that the at-home test was wrong, they were not pregnant, and need not worry. The reality of being pregnant for more than half of the women in this study did not set in until they received “official” confirmation from a doctor.
Seventeen of the 32 unwed mothers reported going to the doctor for purposes of receiving laboratory test results from a physician prior to telling their parents about their pregnancy. The women explained that they wanted to be sure that the at-home test was accurate—that they did not read or take the test incorrectly—before “getting everyone all upset and up in arms” (Lana, par. 27).
Although not all of the remaining women explained why they did not go to the doctor prior to telling parents, the few who did claimed it was due to fear of having their secret
discovered by parents before they were ready to tell. This is surprising given that the participants in this study are adults (and concerns about health care privacy tend to come from adolescents) and the Health Insurance Portability and Accountability Act (HIPAA) ensures protection and confidentiality of their health information and medical records (Klein, McNulty, & Flatau, 1998; U.S. Department of Health and Human Services, 2013). Perhaps their fear stems from still being on their parent’s insurance, as one participant mentioned. The Affordable Care Act now allows young adults to stay on their parents’ health care plan until age 26, an age bracket that includes a majority of the unwed mothers in this study. Any additional charge on an insurance bill could arouse parental suspicion.
Phase II: Reaction to pregnancy confirmation. Confirming pregnancy, by doctor, at-