Relational Support Pathways During First Pregnancy: A Qualitative Study with Implications for Couple-Based Maternal Health Promotion

Abstract

Introduction: A first pregnancy involves bodily changes, emotional concerns, and adjustment to an unfamiliar role. Although husband support is widely recognised as part of pregnancy care, it is often discussed as an individual resource or as a set of supportive behaviours. This study explored how support was experienced by couples and how it developed through their everyday interactions during first pregnancy. Methods: An exploratory qualitative study was conducted with 12 married couples, involving 24 participants who were experiencing their first pregnancy. Participants were purposively recruited from semi-urban and rural communities. Husbands and wives took part in separate in-depth interviews. All interviews were audio-recorded and transcribed verbatim. Data were analysed using Braun and Clarke's thematic analysis. Member checking and peer debriefing were used to support the trustworthiness of the analysis. Results: Five interconnected themes were developed from the participants' accounts. Physical discomfort and emotional changes created new needs within the couple relationship. Support emerged in everyday exchanges, including conversations, attention to changing needs, and efforts to adjust together. The meaning of a husband's response depended partly on how his wife understood that response. Participants also linked their adjustment to shared experiences within the relationship and, for some, to spiritual ways of understanding pregnancy. These accounts informed the proposed relational support pathways, which describe movement from pregnancy-related vulnerability towards adaptation. Discomfort and uncertainty often prompted a need for reassurance and understanding. Husbands described learning how to respond as pregnancy progressed, while wives interpreted those responses in light of their relationship. Similar actions were not necessarily experienced in the same way by every participant. Spiritual beliefs also helped some participants make sense of and accept pregnancy-related difficulties. Conclusion: Participants described first pregnancy as a personal transition experienced within a couple relationship. Communication, emotional responsiveness, changing roles, and the meanings attached to pregnancy shaped how support was experienced. Husband support appeared to develop through repeated interaction between partners rather than remaining a fixed role. These findings may inform couple-based antenatal education that addresses communication, emotional responsiveness, and family involvement.