A concept analysis of women’s vulnerability during pregnancy, birth and the postnatal period.

Aim. To report an analysis of the concept of vulnerability associated with
pregnancy, birth and the postnatal period.
Background. The concept of vulnerability during childbirth is complex and the
term, ‘to be vulnerable’ frequently attains a vague application. Analysis about
vulnerability is needed to guide policy, practice, education and research. Clarity
around the concept has the potential to improve outcomes for women.
Design. Concept analysis.
Data sources. Searches were conducted in CINAHL, EMBASE, PubMed,
Psychinfo, MEDLINE, MIDIRS and ASSIA and limited to between January 2000
– June 2014. Data were collected over 12 months during 2014.
Methods. This concept analysis drew on Morse’s qualitative methods.
Results. Vulnerability during pregnancy, birth and the postnatal period can be
defined by three main attributes: (a) Threat; (b) Barrier; and (c) Repair. Key
attributes have the potential to influence outcome for women. Inseparable sub attributes
such as mother and baby attachment, the woman’s free will and choice
added a level of complexity about the concept.

Conclusion. This concept analysis has clarified how the term vulnerability is
currently understood and used in relation to pregnancy, birth and the postnatal
period. Vulnerability should be viewed as a complex phenomenon rather than a
singular concept. A ‘vulnerability journey plan’ has the potential to identify how
reparative interventions may develop the woman’s capacity for resilience and
influence the degree of vulnerability experienced. Methodology based around
complex theory should be explored in future work about vulnerability.