Embodied experience in pregnancy and post-birth: body image and body-directed attending

Women's experiences of the challenging embodied events of pregnancy and post-birth occur in a cultural context of widespread negative body images. The current research takes a multidimensional, situated and experiential approach to examining women’s body-self relations in pregnancy and post-birth, with a view to identifying factors that underlie and support positive body-self relations. The body image construct in contemporary usage emphasizes body-as-object dimensions of embodied experience. This thesis takes a multidimensional approach, including body-as-subject dimensions, and discerning dimensions of embodied life salient for women themselves. A broadly biopsychosocial approach was adopted, in which body, self and world are understood to exist in a perpetual and mutually influential interrelation with each other and with events and objects. Emphasis was given to experiential, moment by moment aspects of women’s embodied experience, investigating conscious embodied experience in pregnancy and post-birth at two levels – a relatively stable, constructed, storied level (“top-down”), and a plastic, present-oriented, experiential level (“bottom-up”). The purpose of the research was to discern experiential and ideational aspects of positive and negative body images, to investigate the phenomenon of body-directed attending, and to contribute to the understanding of women’s embodiment in pregnancy and postbirth. This thesis employed narrative and phenomenological research methods to elicit and analyze in-depth, first-person accounts of 13 women’s lived experience of embodied life in pregnancy and post-birth. The longitudinal design allowed for analysis of change across the trajectory of pregnancy and post-birth. The women participated in two interviews - the first in mid-pregnancy; the second between 7 and 12 weeks postbirth. The women’s beliefs, ideas and meaning constructions about their bodies were examined through their narratives and descriptions of embodied experiences. Their moment-by-moment experiences of body-self were investigated through phenomenological reflection on acts of body-directed attending. The overarching narrative in the women’s accounts of their embodied experience contains a trajectory of change to each woman’s customary/“normal” body in pregnancy, then recuperation and reintegration of her embodied life post-birth. Three major dimensions of embodied experience were discerned in the data – appearance, sensation and function. Three embodied narrative landmarks emerged in women’s accounts – customary body, pregnant body and post-birth body. A systematic shift was evident in multidimensional embodied focus, from increased internal, sensate focus in pregnancy to increased focus on function and interaction at post-birth. The research identified a basic phenomenological process of body-directed attending which appeared to be part of an ongoing cycling between focal and background somatic attending in everyday consciousness. The content of the women’s body-directed attending took the form of sequences of somatic images with directionality, meaning associations and outcomes. Somatic images found in the data were internal, external and postural, and local (specific to a body part) or global (whole body). An association was found between use of external, local visual images and low body image satisfaction. Evidence is presented for an interpretation of body-directed attending as a feedback system for monitoring the basic health, continuity and identity of body-self, and a mechanism for the bottom-up construction of meaning, with impact on self-state, body image and wellbeing. The body-directed attending and the narrative and phenomenological findings were integrated to provide a top-down, conceptual, and bottom-up, experiential, perspective on body image satisfaction in pregnancy and post-birth. The predominant pattern of body image satisfaction was a trajectory of significant body image threat or challenge in pregnancy, with subsequent successful adaptation for the majority at postbirth, despite the women describing themselves as deviating more from slim ideals than they did pre-pregnancy, and despite conflicts between sexuality and maternity. The factors associated with successful body image adaptation in the post-birth context were an increase in ideational and experiential focus on function and interaction, and the use of body-directed attending sequences culminating in the use of internal, global, sensed somatic images. Conversely, factors associated with post-birth body image dissatisfaction were a preoccupation with the appearance dimension of embodied experience, and the use of body-directed attending sequences culminating in the use of external, local, visual somatic images. The findings provide evidence that in adapting to the body image challenges of pregnancy and post-birth, a majority of women utilize a shift in multidimensional embodied focus towards function and interaction. This shift appears to result in part from an inherent embodied tendency in the events of childbearing, and in part from adaptive cognitive strategies that women actively employ. The findings also provide evidence that women’s habits of body-directed attending and somatic imaging impact on their body image satisfaction. It also appears that body-directed attending and somatic imaging are specific and influential aspects of human functioning. Suggestions are made for further research into the process, content and functions of body-directed attending, and its relation with body image.