- General information of participants(see Table 2 )
Table 2 General information of participants
Project
|
n=15
|
|
Project
|
n=15
|
Age(x±S, year)
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37. 67±1. 19
|
|
Delivery mode of the first child[n(%)]
|
|
Highest Educational Qualification[n(%)]
|
|
Caesarean section
|
3(20. 00)
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Senior high school
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3(20. 00)
|
|
Vaginal delivery
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12(80. 00)
|
Junior college
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3(20. 00)
|
|
Gender of the first child [n(%)]
|
|
College
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9(60. 00)
|
|
Male
|
9(60. 00)
|
Postpartum time(x±S, day)
|
3. 00±0. 73
|
|
Female
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6(40. 00)
|
Planned pregnancy [n(%)]
|
|
Delivery mode of the second child[n(%)]
|
Yes
|
10(66. 67)
|
|
Caesarean section
|
10(66. 67)
|
No
|
5(33. 33)
|
|
Eutocia
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5(33. 33)
|
Employed during pregnancy[n(%)]
|
|
|
Gender of the second child[n(%)]
|
|
Yes
|
11(73. 33)
|
|
Male
|
8(53. 33)
|
No
|
4(26. 67)
|
|
Female
|
7(46. 67)
|
|
|
|
Time between two births(x±S, year)
|
12. 8±2. 17
|
2. M-GTA results revealed four major themes about the psychological experience of the elderly multipara; these were: life choice; mixed feelings of being a mother again; the backbone of family; be cautious to have a second child. Nine sub-themes were further elaborated, and these included: willing or not to have a second child; calmness and second heartbeat of experienced mothers; helplessness and restlessness of the elderly body; concerns about the future; independent parenting of children; family burden; the second child should be born as early as possible.With the full liberalization of the second child policy, the "second child fever" has gradually emerged. Most of the elderly multipara were affected by the general environment and decided to have a second child under the premise that economic conditions and their capabilities would remain similar. However, some elderly women decided to have a second child without being prepared, regardless of the circumstances, and considering the advantages of a second child being a companion for an older child.
From pregnancy to childbirth, they experienced a series of psychological experiences: As elderly multipara, the contour and heartbeats of infants made them excited once again; however, they became more worried about the health condition of the child rather than their own health care; Due to the advanced age, most of them had severe reactions during pregnancy and difficulty in giving natural birth. Therefore, they had to choose the cesarean section along with slow and hard postpartum recovery. Besides the long and arduous process of raising children from scratch and not being able to spend time consistently with the child also overwhelmed most elderly multipara; Most of them were indispensable in taking on central family and work responsibilities and the arrival of the second child made them have no choice but to resign because they could not balance family and work. As older women with second children, they offered their experience and suggested caution, calling on women not to blindly have a second child, and to be mentally and physically prepared, and finally decide as soon as possible if energy permits. (see Figure 1)
Theme 1: Life decision
It is a major life decision for elderly multipara to have a second child. One reason that explained this decision was the "second child fever", along with the economic condition and the feasibility to rear one more child. Another reason consisted in the unplanned pregnancy. When a woman is not prepared to raise a second child, she may make a decision under the pressure of other family members, and usually the focus is in having a second child that would provide company for an older child. C: "Well, due to recent improvement of our economic condition, I felt that, my current child was feeling a little lonely, and this gave me the urgency to discuss the option of having a second child with my husband”. D: “Many colleagues, relatives and friends around me were giving birth to a second child and brainwashed me and my husband into doing so too. My mom persuaded me by saying ‘Your only child will have to take care of four elderly people in the future, how can she manage that? Don’t you worry about she will be stressed out?’ These words touched me, maybe, and I finally decided to have one more child after thinking for a long while.” F: “Honestly, my husband and I have been struggling since the two-child policy was rolled out because we wanted to give our son a sibling that would provide company, while there are no elderly people in my home and I am not young any longer. We hadn’t made up our mind but now since I’m pregnant, we decided to have it.”
Theme 2: Mixed feelings of being mother again.
The key theme ‘Mixed feelings of being a mother again’ considers that the participants went through a range of psychological transformations from pregnancy to delivery. Although pregnancy at an advanced age is extremely difficult, the elderly multipara was calm because they had the experience of being a mother once and that provided the happiness and excitement of motherhood again. At the same time, they are more worried about the health condition of the child due to advanced age. They inevitably lack confidence, thinking about the effort needed to raise a baby from scratch with the worry that they may not see the future of the child. Among the sub-themes, "helplessness and anxiety of the elderly body" and " calmness and second heartbeat of experienced mothers " existed in opposition.
Helplessness and restlessness of the elderly body: Most of the older women who gave birth to a second child had severe reactions during pregnancy. They were veryworried about the health of their children during pregnancy. The Cesarean section had to be chosen due to the difficulties in giving birth, making the recovery after delivery slow. E: “This time, it seems to be really different from the first child, regardless of reaction and physical strength. In the first three months, the reaction was bad and so uncomfortable, I vomited when I ate, or I feel like vomiting when I smelt something wrong. I could not sleep well at night, so I felt so worried. I felt much more uncomfortable than the first child pregnancy.” F: “This time will certainly be harder because of the cesarean delivery. Besides, I am ten years older than before. The physical situation is getting worse as well. I’m tired after just walking few steps and want to do nothing but to lie down”.
Calmness and second heartbeat of experienced mothers: Because of the experience as a mother, the elderly multipara pays more attention to the health of the second child than their own health care during pregnancy. The 4D contour, heartbeats, and creamy fragrance of infant trigger natural motherhood once again which made them extremely cheerful and happy: D: “Because I am an elderly mother, I paid more attention to the child’s health during pregnancy. But I was not as nervous as the last time since I have now experience.” E: “The baby’s 4D contour can be seen clearly and they look energetic and cute. Although it has been more than ten years since I had my first child, I’m still excited to see that again.”. D: “A new-born baby is so adorable! Had I not been pregnant again, I would have forgotten how nice the skin and the milky fragrant of the baby is! The family was excited around her as if they had never seen a baby.”
Concerns about the future: worrying about the difficulty and length of raising a baby from scratch and fear of aging and not being able to see the future of the child. A: “The first child just entered the first grade and the second one has just been born, which means there is a gap of about six years between them. I can’t even imagine how I will raise this child into an adult.”C: “I’m already 38 years old while he was just be born so I will be over sixty years old when he grows up. I just feel like, there is a huge gap between our ages. I am afraid that I will not be in good health in the future. I am afraid that I will not be able to see him getting married and having children.
Theme 3: Backbone of family
The key theme ‘Backbone of family’ comments mainly reported that the elderly multipara with a second child have to take care of the older child, the newborn and the whole family. They are the indispensable backbone of the family. Some of them would choose to resign from work because they were too burdened and some of them continued to do heavy-duty work under financial pressure.
Independent parenting of children: All of the participants decided not to rely on the elderly (grandparents), and independently raise their two children. Because of the second child, the elderly mothers had to consider the double pressure of work and family. After evaluating the family's financial situation, some chose to resign, while others could only continue to work under the heavy burden. A: “I have no option but to resign. To be honest, I am worried about committing my first child to my parents’ care, because I took care of my first baby since he was born. Since I’m pregnant and the school is far from home, there is absolutely no way to drive back and forth.” D: “I originally planned to quit my job in order to take care of my two children, but because my family situation is complicated and my husband’s income is not enough, If I resigned, my husband would have been under great pressure. So, after discussing it, I decided not to resign, but continue to work harder.
Family burden: The elderly multipara is independent and competent enough to deal with everything in the family, even during their pregnancy: A: “I was still driving after being pregnant for over 36 weeks to pick up the first child. The circumstances did not permit hospitalization. How I wish I could insist until my child finished her final exams. However, the only thing my parents cared about wasthat if I were hospitalized there would be no one to take care of the family and to tutor my first child in homework” C: “I take care of everything in the family, including the studying stuff of my first child in second grade in junior high school. By the way, the grandparents are too busy to help me.”
Theme 4:Be cautious to have a second child.
The key theme ‘Be cautious to have a second child’ revealed that the elderly multipara advised the majority of women not to blindly have a second child from their own experience. They need to be fully prepared in all aspects and decide as soon as possible.
Having a second child blindly is not advisable: Elderly mothers with second children believe that other families need to carefully consider the matter of having a second child, and encourage other families not to have a second child if they do not have the ability to raise one more child. A: “I think having a baby should be determined carefully since giving birth is undemanding but then children need to be looked after and educated. If you are not capable enough or not confident about raising children well, you should be prudent in making decisions. Don’t blindly encourage fertility.” J: "I think women have to think about their future before having a second child, especially about their work. See, I had to resign to look after the child. Actually, I really did not want to be a housewife, but I had no choice."
The second child should be born as early as possible: Before the elderly multipara
decides to have a second–child, they must comprehensively evaluate their age and physical condition, and they must decide to have a second child as early as possible in consideration of their health conditions. D: "I think a woman should have a child earlier, and she should be fully prepared before she wants it. Otherwise, it will be bad for hers and the child’s health and she will be hassled by the feeling of unease during pregnancy." E: “If you plan to have a second child, you have to plan early and stop being in twominds. You can’t let nature take its course as women’s energy tends to be used up. Otherwise, not only you but your children will also have a rough time.”