{'fraction_non_alphanumeric': 0.029469901168014376, 'fraction_numerical': 0.007547169811320755, 'mean_word_length': 4.852786540483701, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Book Review: Understanding Uncertain Motherhood: A Phenomenological Study of Women in High-Risk Perinatal Situations, by M. Colleen Stainton, Sheila Harvey, and Deborah McNeil

“After months of ineffectively trying to condense the core findings to meet the space requirements of a journal” (Stainton, Harvey & McNeil, 1995, p. xii), Understanding Uncertain Motherhood was published by the authors as a monograph. The study was developed in 1987 with Heidegger's (1927/1962) phenomenology as the framework of the study design. Thus, women were asked to describe their lived experiences of high-risk perinatal situations, which included high-risk pregnancy, high-risk newborn, or both. The research was a longitudinal study of a convenience sample of 27 women. Each participant was followed throughout by the same interviewer. 
 
Women were recruited as early in the high-risk perinatal situation as possible and followed until 6 months after delivery. Ten women were recruited from ambulatory care facilities, 10 from an inpatient antepartum unit, and 7 when their babies were admitted to the Neonatal Intensive Care Unit (NICU). Both the University of Calgary and the participating hospital granted Institutional Review Board Approval. The participants gave their informed consent and were told that the purpose of the study was to “understand their experiences in the pregnancy and/or neonatal period” (Stainton, et al., 1995, p. 16). The word uncertainty was not used in the consent form because the researchers did not want to create any specific set of responses from the participants. The women kept diaries and participated in regularly scheduled tape-recorded interviews for the duration of their enrollment in the study. The interviews consisted of the women's responses to the question “What is it like to be in a high-risk situation?” (Stainton, et al., 1995, p. 17). Often, the scheduled interviews were augmented by participants' calls to share what was happening to them. Not all women “finished” telling their stories at the arbitrarily set 6 months postdelivery ending point, so their participation continued until the interviewer and the participant agreed that the story was “complete.” No women withdrew from the study. This was true even for those women whose infants died either before or after delivery. 
 
Hermeneutic interpretive analysis was conducted, and the process of data collection and analysis spanned 2 years. Consensual validation was achieved by inviting study participants to review and comment upon preliminary findings. Dimensions within the experience of perinatal uncertainty were identified as (a) an elongation of time (i.e., waiting), (b) feeling fear, (c) loss of control and identity, (d) being alone with the responsibility, (e) changed family relationships and interaction, (f) fatigue, grief, and loss, (g) needing to be known and understood, and (h) mismatch in realities. The caring practices devised by the women and their partners to mediate the uncertainty included “focusing on the possibilities while knowing the problem within the situation, bracketing time into manageable segments, giving over of the bodies and time to do a job of ensuring safety for themselves and the infant, taking up the role of doing a job, protecting self after previous loss, intensified giving while needing to receive, seeking information that is meaningful; balancing the perspectives of positive and negative events, and maintaining family relationships and functioning (Stainton, et al., 1995, p. 36). 
 
The authors describe how they define and delineate their roles as clinicians and researchers and discuss how they were able to function as clinicians without influencing the women's perceived experiences. At the same time, they discuss how their roles as co-participants with the women in the study influenced their ability to care for these women and other women undergoing similar experiences. They discuss how they safeguarded the primacy of the data while providing the study participants with the information the women needed to continue with their high-risk situations. 
 
The monograph is well written, and the text is sufficiently thick to allow the reader to evaluate the relevance of the categories and themes derived by the researchers. This study will facilitate nurses' understanding of women's experiences with uncertainty during high-risk perinatal situations. The monograph will also be meaningful to all who work with high-risk perinatal clients at any point on the perinatal continuum. 
 
I hope the authors might consider submitting this manuscript to scholarly, peer-reviewed journals for consideration and possible publication. The peer-review procedure is an important step in the research process and will provide the authors with valuable feedback from fellow scholars. It will also allow this important piece of work to become part of our research-based practice literature in a way not possible for a privately published monograph. The women who participated in this research deserve to have their experiences become part of the body of knowledge on which we build our practice. 
 
 
Confronting Challenges 
One sees great things from the valley; only small things from the peak. 
 
—G. K. Chesterton 
 
I have learned that success is to be measured not so much by the 
 
position that one has reached in life as by the obstacles which he has 
 
overcome while trying to succeed. 
 
—Booker T. Washington 
 
At the core of life is a hard purposefulness, a determination to live. 
 
—Howard Thurman