Have you ever experienced something happen to your health that motivated you to make a positive healthy change? It might have been something as simple as being told you need a filling and deciding to eat less sugar, or it could have been something more significant like receiving a test result or a hospital admission, that encouraged you to make a healthy change. These types of experiences, which motivate you to modify your lifestyle, are commonly known as ‘teachable moments’. Pregnancy is also suggested to be a teachable moment, as the experience of finding out you’re pregnant, and everything that goes along with that, often encourages women to think more about their health, and to make positive lifestyle changes as a result.
Whilst I was doing my PhD, I explored this concept – is pregnancy really a teachable moment, or do all the symptoms and issues that come with it limit the potential for meaningful change? In this blog post, I’ll be doing a bit of a deep-dive into what teachable moments really are, and explaining a bit about my research.
Teachable moments - the theory behind it
Whilst a teachable moment is thought to occur as a result of a specific ‘health event’ (i.e., pregnancy, test results, hospital admission), there’s slightly more to it than that. In addition to the actual health event itself, it’s been suggested that the experience needs to trigger heightened emotions, a change in identity or social role, and an increase in concern about risks related to that particular experience. This theory was developed by researchers working at Harvard University and Duke University, back in 2003 (1).
Pregnancy as a teachable moment
Based on this theory, pregnancy could therefore be thought of as a particularly powerful teachable moment. This is because pregnancy often generates lots of quite intense emotions, be that elation, joy, fear, or anxiety. For first time mums in particular, becoming pregnant is also likely to change the way someone thinks about themselves (as they adjust to the idea of being a parent) and what that means for them and their place in society. Finally, it’s very normal for women to experience a range of concerns and fears about their pregnancy and a desire to protect their baby from any harm.
Additional factors affecting antenatal lifestyle change
The problem with this theory though, is that it fails to take into account the impact of physical pregnancy symptoms on women’s ability, and motivation, to make healthy changes. If you’re feeling sick, suffering with aches and pains, or just feeling lethargic, there’s less chance you’re going to feel motivated to exercise, or to rustle up a healthy dinner. This theory also doesn’t consider the influence of external factors on women’s behaviour, such as the influence of her partner, family, and friends, or the influence of her physical environment. What I mean by this is how easy it is to access healthy food or whether there are healthy or unhealthy food options available in her home or workplace, for example.
For some women, becoming pregnant can certainly act as a hugely motivating factor to make healthier lifestyle choices – think how many people try to quit smoking or reduce their alcohol intake once they know they’re pregnant! However, there are evidently a great deal of other factors at play which may make it more difficult for some women to make positive changes, especially in relation to exercise and dietary behaviour, which are often disproportionately affected by pregnancy symptoms.
Developing a better understanding
Having explored this in my research, I realised that it was necessary to develop a theoretical understanding of behaviour change during pregnancy that takes into account all of the unique factors that might make healthy lifestyle changes harder, or easier, at this time. As such, I developed a pregnancy-specific theory which considered the impact of six main influences on women’s health behaviour. These include: (1) the influence of physical changes (bodily changes and physical symptoms), (2) the external environment and lifestyle factors, (3) a woman’s sense of identity, (4) the influence of perceived risk and worry, (5) social factors (including relationships and social roles/expectations), and (6) the influence of knowledge and information seeking.
So, is pregnancy a teachable moment for healthy lifestyle change? Based on my research, I would say that yes, it can be. At the very least, pregnancy provides women with an opportunity to take stock of their health behaviour and consider if they want to do something differently. But there are a multitude of things that might make this more challenging, all of which need to be understood and appreciated to successfully support healthy lifestyle change.
This understanding informs the way I work with my coaching clients. I adopt an evidence-based approach, based on my own research (amongst others), and provide support that takes into account all of the nuanced and varied issues faced by women when trying to make healthy lifestyle changes at this time.
If you are interested to find out more about the research I did on this topic during my PhD, a list of my publications can be found here.
(1) McBride, C. M., Emmons, K. M., & Lipkus, I. M. (2003) Understanding the potential of teachable moments: the case of smoking cessation. Health Education Research,18(2), 156-70.