GETTING TO 40 WEEKS: CONSTRUCTING THE UNCERTAINTY OF DUE DATES

In the United States as many as 15% of births occur before 39 weeks because of elective inductions or cesarean sections. This qualitative study employs a grounded theory approach to understand the decisions women make of how and when to give birth. Thirty-three women who were pregnant or had given birth within the past two years participated in key informant or small group interviews. The women’s birth narratives and reflections reveal how they construct the uncertainty of their due dates and how this construction influences their birth decisions. Problematic integration theory is used to analyze this construction and identify points of influence. The results suggest that women construct the uncertainty of due dates as a reason to wait on birth and as a reason to start the process early. The results suggest that information about a baby’s brain development in the final weeks of pregnancy may persuade women to remain pregnant longer. The results demonstrate the utility of using problematic integration theory to understand a medical situation that is the result of epistemological and ontological uncertainty. The analysis suggests the existence of a third type of uncertainty, axiological uncertainty. Axiological uncertainty is rooted in the values and ethics of outcomes.