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UNDERSTANDING the CHILDBIRTH EXPERIENCES of CHILDHOOD SEXUAL ABUSE SURVIVORS: a PHENOMENOLOGICAL STUDY by Caitlin Mathewson Bscn

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UNDERSTANDING the CHILDBIRTH EXPERIENCES of CHILDHOOD SEXUAL ABUSE SURVIVORS: a PHENOMENOLOGICAL STUDY by Caitlin Mathewson Bscn UNDERSTANDING THE CHILDBIRTH EXPERIENCES OF CHILDHOOD SEXUAL ABUSE SURVIVORS: A PHENOMENOLOGICAL STUDY By Caitlin Mathewson BScN, (McMaster, 2008) A thesis presented to Ryerson University in partial fulfillment of the requirements for the degree of Master of Nursing in the Program of Nursing Toronto, Ontario, Canada, 2016 © Caitlin Mathewson 2016 AUTHOR'S DECLARATION I hereby declare that I am the sole author of this thesis. This is a true copy of the thesis, including any required final revisions, as accepted by my examiners. I authorize Ryerson University to lend this thesis to other institutions or individuals for the purpose of scholarly research. I further authorize Ryerson University to reproduce this thesis by photocopying or by other means, in total or in part, at the request of other institutions or individuals for the purpose of scholarly research. I understand that my thesis may be made electronically available to the public. ii UNDERSTANDING THE CHILDBIRTH EXPERIENCES OF CHILDHOOD SEXUAL ABUSE SURVIVORS: A PHENOMENOLOGICAL STUDY Abstract By Caitlin Mathewson Master of Nursing Ryerson University, Toronto, 2016 This study describes the childbirth experiences of survivors of childhood sexual abuse using an interpretative phenomenological approach. Data collection involved in-depth, semi-structured interviews of four women who gave birth to a baby within the last five years. Using Interpretative Phenomenological Analysis, three superordinate themes emerged: control, anxiety, and detachment. This contributes to the current body of research by extending knowledge on what it means to experience childbirth for survivors of childhood sexual abuse, told by the woman herself. These findings are especially important in understanding what is required in providing safe, sensitive care for all childbearing women, and has important implications for practice, education, and further research. iii Acknowledgements First and foremost I would like to sincerely thank my thesis supervisor, Dr. Sherry Espin. Dr. Espin inspired me to go beyond writing about a subject I was passionate about, to complete a piece of work with significant impact. Dr. Espin inspired in me a confidence to embrace the journey of exploring something difficult through qualitative research. I also would like to thank my committee members: Dr. Ryan Van Lieshout, Dr. Sharon Dore, and Dr. Patricia McNiven. Without the expertise and wisdom from you all, I could not have completed this work. Your dedication to this study, despite your many demands, continued to motivate me to realize my research goals. Having a largely interprofessional thesis committee highlighted beautifully the importance of this research to so many. You all brought something so proudly different to the process, of which I am truly thankful. I would also like to provide a heartfelt thank you to my husband Stephen, who has reminded me daily of my capacity for greatness, and who has taken on much of the burden of me being a full-time student, among my other roles. I am also thankful to God for providing Stephen and I a little blessing amongst the challenge of completing my thesis. The context of my pregnancy has provided new meaning to this work, and the little kicks have been subtle reminders to complete this work before a personal deadline. Last but certainly not least, I would like to thank the four courageous women who participated in this research study. Your stories were incredibly rich, moving, and touched me so profoundly. You were, above all else, my motivation to complete this work. Thank you for your dedication in partnering with me to realize a brighter future. iv TABLE OF CONTENTS Abstract ......................................................................................................................................... iii Acknowledgements ...................................................................................................................... iv The Social Context of Birth ....................................................................................................... viii Chapter 1: Introduction ............................................................................................................... 1 Problem Statement ................................................................................................................................. 3 Study Purpose and Research Question ................................................................................................. 4 Chapter 2: Review of the Literature ........................................................................................... 5 Definitions ................................................................................................................................................ 5 Historical Perspectives of Childhood Sexual Abuse ............................................................................ 7 Theoretical Perspectives on Childhood Sexual Abuse ........................................................................ 8 Attachment Theory and Sexual Abuse ................................................................................................. 8 Finkelhor’s Precondition Theory ........................................................................................................ 10 Prevalence of Child Sexual Abuse ....................................................................................................... 10 Sequelae of Child Sexual Abuse .......................................................................................................... 11 Child Sexual Abuse and Childbearing Women ................................................................................. 12 Intrapartum experience. .................................................................................................................. 15 Summary ............................................................................................................................................... 23 Chapter 3: Methodological Approach ...................................................................................... 25 Research Question ................................................................................................................................ 25 Overview of Methodology .................................................................................................................... 25 v Interpretative Phenomenological Analysis ......................................................................................... 28 Sampling ................................................................................................................................................ 30 Sample Size ............................................................................................................................................ 30 Inclusion Criteria .................................................................................................................................. 31 Recruitment ........................................................................................................................................... 31 Consent .................................................................................................................................................. 32 Ethics ...................................................................................................................................................... 33 Data storage ........................................................................................................................................... 34 Data Collection ...................................................................................................................................... 35 Data Analysis ......................................................................................................................................... 35 Rigour .................................................................................................................................................... 38 Summary ............................................................................................................................................... 40 Chapter 4: Results ....................................................................................................................... 41 Figure 1. Coding Tree .......................................................................................................................... 42 Participants ........................................................................................................................................... 42 Synthesis ................................................................................................................................................ 43 Control ................................................................................................................................................... 44 Figure 2. Coding Tree: Control ........................................................................................................... 44 Figure 3. Coding Tree: Control, Relational ...................................................................................... 46 Figure 4. Coding Tree: Control, Contextual ...................................................................................... 51 Anxiety ..................................................................................................................................................
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