Negotiating Activity Restriction: A Grounded Theory of Home Management of Preterm Labor

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Abstract
Preterm birth, preceded by preterm labor, is a significant perinatal problem. This article describes a qualitative, grounded theory study in which 25 women treated at home for preterm labor were interviewed. The purpose was to investigate how women managed this treatment, specifically bed rest, within the context of their day-to-day life. Three management phases were identified: Phase 1, the diagnostic phase, encompassed the circumstances around the diagnosis and subsequent realization that one was at risk to deliver preterm; in Phase 2, the negotiation phase, the women confronted their multisituated reality and negotiated their needs and wants that conflicted with it; and in Phase 3, the preparation phase, the women shift their focus from prevention of preterm delivery to preparation for parenthood. The proposed theory that women manage their activity restriction through negotiations in which they attempt to balance their perceived risk against a calculus of salient variables represents a new perspective in preterm birth prevention.

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