Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

Aileen Gariepy


The goal of this thesis is to characterize self-reliance during pregnancy as described by a diverse urban cohort of women. We report on qualitative findings from a study conducted to explore the impact of a new pregnancy on women's lives based in New Haven, CT from June 2014 to June 2015. Each participant completed an enrollment survey and an in-depth semi-structured interview about intentions, thoughts, and feelings about her new pregnancy. We used framework analysis to identify concepts from our data and to assess thematic relationships. Eighty-four English-speaking women completed qualitative interviews. Participants averaged 26 years of age, and their pregnancies averaged 7 weeks estimated gestational age. The majority identified as Black (54%) or Hispanic (20%). Most (61%) had not intended to get pregnant and most (65%) planned to continue their pregnancy and parent. Forty-eight percent of women discussed self-reliance (the need to depend on one's own efforts and abilities) in relationship to pregnancy and parenting. The theme of self-reliance consisted of several subthemes: 1) past experiences of self-reliance, 2) expectations of self-reliance in motherhood, 3) financial stability, 4) decision making about this pregnancy, and 5) self-reliance in parenting. Women's belief in their own self-reliance as well as recognition of the limits of self-reliance had a substantial impact on their thoughts, feelings, and decision-making about a pregnancy. We conclude that self-reliance is an important aspect of women's reproductive lives and choices, and may be an important strategy women use to cope with diminished social support and increased life stress during pregnancy. Healthcare providers and researchers should aim to support self-reliance among their pregnant patients, and to further evaluate outcomes and interventions related to self-reliance in pregnancy.

Open Access

This Article is Open Access