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The response of one primigravida to the situation of persistent anemia during pregnancy.

This descriptive longitudinal case study examines the nature and purposes of the responses of one primigravida to the situation of persistent anemia during pregnancy. Selected literature in the following topic areas relevant to pregnancy complicated by serious illness is reviewed: stress, adaptation, defense and coping; pregnancy, illness and uncertainty; and body image implications of pregnancy and blood loss. Following unstructured interviews and observations in natural settings, process recordings were prepared and analyzed by the nurse-investigator to identify major behavioral themes. After repeated analysis and refining of categories, six mutually exclusive groups of responses were defined, and their frequency of use calculated: conditional compliance (34%), expressing affective states (24%), monitoring (23%), using support (11%), replenishing (5%), and using knowledge (3%). The subject used these responses, singly or in combination, to deal with various elements of perceived threat inherent in her anemic condition, the treatment of that condition, and her relationship with caregivers. The findings reveal one person's creative use of resources (inner and environmental) to develop a flexible response pattern effective in limiting or preventing stress associated with a potentially life-threatening condition.