Clinical Scholarship The Experience of Becoming a Mother for Single, Unpartnered, Medicaid-Eligible, First-Time Mothers Rebecca Keating-Lefler, Margaret E. Wilson Purpose: To understand the experience of becoming a mother for single, unpartnered, Medicaid-eligible, first-time mothers in the United States and to discover the basic social psychological problem and process experienced by the mothers during the first 3 months postpartum. Design: Grounded theory. Methods: Semi-structured interviews were conducted and audiotaped with 20 single, unpart- nered, Medicaid-eligible, first-time mothers at 1, 2, and 3 months postpartum. Data analysis was completed using the constant comparative method of data analysis. Findings: The women used the basic social psychological process of “reformulating life” to manage their “grieving of multiple losses.” “Reformulating life” included “believing in future possibilities,” “submerging self in the mother role,” “daring to dream life’s options,” “development of a new self-definition, identity, and future,” and “risking a new life course: attempting new roles.” Social support and personal resilience facilitated the basic social psychological process of “reformulating life.” Conclusions: Single, unpartnered, Medicaid-eligible, first-time mothers in this study managed their “grieving multiple losses” by “reformulating life.” The uniqueness of this substantive theory is the relationship between pregnancy, loss, and grief. JOURNAL OF NURSING SCHOLARSHIP , 2004; 36:1, 23-29. C 2004 SIGMA THETA TAU INTERNATIONAL. [Key words: Medicaid-eligible mothers, loss, grief ] * * * S ignificant sociocultural, socioeconomic, and sociopo- litical changes have taken place during the last 2 decades in the United States (US) that greatly affect single, Medicaid-eligible mothers. The proportion of births to unmarried women in 2002 was 34.4% (Martin et al., 2003), which is an 86% increase since the early 1980s. Social scholars have predicted that if the rate of births to single women continues at the same pace it will increase to one- half of all births in 2005 (Ludtke, 1997). Single, poor women and their children are the largest group of Americans at the lowest portion of the economic structure (Sidel, 1996). Recent changes in welfare policy have further decreased the number of people entitled to benefits, including Med- icaid, since the 1996 reform act. One in 10 families now are below the poverty line, and the great divide be- tween the wealthy and the poor is increasing (Quindlen, 2002). Single, poor women and their families tend to be marginalized in the social, political, and health care systems (Hildebrandt, 2002), and their interests are inadequately represented (Banerjee, 2002). Understanding the needs and concerns of low-income, sin- gle mothers and the effect poverty has on their health and well-being and that of their children is of vital importance to their futures. It is the first step toward developing interven- tions and policies to address their physical, emotional, and environmental health disparities. “The personal experience of every woman has worth and should be understood in all its complexity and richness. Understanding women’s expe- rience in the social and political context of their lives is nec- essary” (Thompson, 1992). The purposes of this grounded theory study were (a) to understand the experience of be- coming a mother for single, unpartnered, Medicaid-eligible, first-time mothers during the first 3 months postpartum; and (b) to discover the basic social psychological problems these women encountered being a mother, and the processes they use to manage the problems. This understanding should lead to a substantive theory about their experience. Rebecca Keating-Lefler, PhD, Gamma Pi , Assistant Professor; Margaret E. Wilson, PhD, Gamma Pi , Associate Professor; both at the Univer- sity of Nebraska Medical Center, Omaha, NE. Correspondence to Dr. Keating-Lefler, 8518 North 48 Circle, Omaha, NE 68152. E-mail: rkeating@ unmc.edu Accepted for publication July 30, 2003. Journal of Nursing Scholarship First Quarter 2004 23