Resolving the uncertainty of preterm symptoms: women's experiences with the onset of preterm labor.

OBJECTIVE To describe expectant women's experiences with the onset of preterm labor. DESIGN Qualitative, using grounded theory methods. SETTING Southwestern tertiary women's hospital. PARTICIPANTS Thirty pregnant women who were less than 35 weeks gestation, had experienced preterm labor within the past 7 days, and had no previous experience with preterm labor. DATA SOURCE Taped and transcribed interviews. RESULTS Themes that emerged from the interview data included the following: recognition and naming of sensations, a consistent pattern of attribution of symptoms, the threat or risk inferred by the attributed cause of the symptom pattern, the associated certainty or uncertainty about these attributions, the process of interpreting and verifying symptom meaning, and the decision to self-manage the symptoms or engage health care assistance. The core process of women experiencing the onset of preterm labor symptoms was identified as "resolving the uncertainty of preterm labor symptoms: recognizing and responding to the possibilities." CONCLUSIONS Preterm labor often is not within expectant women's consciousness. They may attribute the symptoms to nonthreatening causes, which results in delays in seeking care for preterm labor. Education about symptom patterns at the onset of preterm labor will increase the probability that women and their health care providers will recognize and interpret the early, subtle symptoms that herald the onset of preterm labor. Uncertainty in illness theory and attribution theory offer frameworks for understanding women's experiences with the onset of preterm labor.