Prenatal harmful substances: Thai pregnant women’s experiences


prenatal harmful substances
pregnant women
qualitative study

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Tantanokit, J., Sansiriphun, N., Sripichyakan, K., & Klunklin, P. (2023). Prenatal harmful substances: Thai pregnant women’s experiences. Belitung Nursing Journal, 9(4), 302–312.
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Accepted for publication: 2023-07-12
Peer reviewed: Yes

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Background: The exposure of unborn babies to harmful substances during prenatal stages can lead to fetal anomalies, emphasizing the significance of pregnant women’s practices in ensuring optimal fetal outcomes. However, there is a lack of understanding regarding this issue from the perspective of pregnant women.

Objective: This study aimed to describe the experiences of pregnant women in avoiding harmful substances to their unborn babies.

Methods: This study used a qualitative descriptive approach. Data were collected between September 2020 and April 2021 through in-depth interviews with 17 pregnant women purposively selected from two hospitals in southern Thailand. Data were transcribed verbatim and analyzed using thematic analysis.

Results: Four themes emerged from the participants’ experiences: 1) understanding of harms, which included substance characteristics, exposure characteristics, body’s protective mechanism, personal experiences, and obtained information; 2) practices for safety, which consisted of food safety, work safety, ambient air safety, and safety in personal/household products; 3) challenges in avoiding harmful substances, which were unrecognition, unavailability of safe substances, discomfort and inconvenience, inevitability, and family traditions; and 4) overcoming the challenges through personal changes, obtaining support, and ensuring a peaceful mind.

Conclusion:  The findings provide valuable insights into prenatal exposure to harmful substances, which can serve as a basis for developing comprehensive guidelines for best practices. It is crucial for nurses to receive training that enables them to educate pregnant women, enhancing their awareness of important harmful substances and promoting effective methods for maintaining safety in their daily activities. Additionally, nurses can develop interventions to empower pregnant women to overcome challenges by involving significant individuals, particularly family members, in providing support and creating an optimal prenatal environment.


Copyright (c) 2023 Jatuporn Tantanokit, Nantaporn Sansiriphun, Kasara Sripichyakan, Pimpaporn Klunklin

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Declaration of Conflicting Interest

All authors declared no potential conflict of interest in this study.


The authors acknowledge the participants in this study.

Authors’ Contributions

Each author contributed significantly to the conceptualization, design, data collection, and analysis. All authors contributed to the writing of the manuscript and approved the final draft.

Data Availability

The data in this study are available from the corresponding author upon a reasonable request.

Declaration of Use of AI in Scientific Writing

None to disclose.


Ahiable, D. Y. (2020). Adaptation experiences of family caregivers of children with congenital birth defects in the Accra metropolis [Master Thesis, School of Nursing, College of Health Sciences, University of Ghana Legon]. Ghana.

Albouy-Llaty, M., Rouillon, S., El Ouazzani, H., Group DisPro, S. E., Rabouan, S., & Migeot, V. (2019). Environmental health knowledge, attitudes, and practices of French prenatal professionals working with a socially underprivileged population: A qualitative study. International Journal of Environmental Research and Public Health, 16(14), 2544.

Artieta-Pinedo, I., Paz-Pascual, C., Grandes, G., & Espinosa, M. (2017). Framework for the establishment of a feasible, tailored and effective perinatal education programme. BMC Pregnancy and Childbirth, 17, 58.

Bjørklund, G., Chirumbolo, S., Dadar, M., Pivina, L., Lindh, U., Butnariu, M., & Aaseth, J. (2019). Mercury exposure and its effects on fertility and pregnancy outcome. Basic & Clinical Pharmacology & Toxicology, 125(4), 317-327.

Boyles, A. L., Beverly, B. E., Fenton, S. E., Jackson, C. L., Jukic, A. M. Z., Sutherland, V. L., Baird, D. D., Collman, G. W., Dixon, D., & Ferguson, K. K. (2021). Environmental factors involved in maternal morbidity and mortality. Journal of Women's Health, 30(2), 245-252.

Cunningham, F. G., Leveno, K. J., Dashe, J. S., Hoffman, B. L., Spong, C. Y., & Casey, B. M. (2022). Williams Obstetrics (26th ed.). New York City: McGraw-Hill Education.

Farrow, A., Anhäuser, A., & Moun-Ob, A. (2022). The burden of air pollution in Thailand 2021.

Firouzan, V., Noroozi, M., Mirghafourvand, M., & Farajzadegan, Z. (2018). Participation of father in perinatal care: A qualitative study from the perspective of mothers, fathers, caregivers, managers and policymakers in Iran. BMC Pregnancy and Childbirth, 18, 297.

Flocks, J., Kelley, M., Economos, J., & McCauley, L. (2012). Female farmworkers’ perceptions of pesticide exposure and pregnancy health. Journal of Immigrant and Minority Health, 14, 626-632.

Fontalba-Navas, A., Zafra Aparici, E., Prata-Gaspar, M. C. d. M., Herrera-Espejo, E., Company-Morales, M., & Larrea-Killinger, C. (2020). Motivating pregnant and breastfeeding women in spain to avoid persistent toxic substances in their diet. International Journal of Environmental Research and Public Health, 17(23), 8719.

Hammer, R., Gouilhers, S., Radu, I., Pehlke-Milde, J., & Meyer, Y. (2022). Uncertainty, manageability and individuation: A longitudinal qualitative study of women's conceptualisations of risk from pregnancy to breastfeeding—the case of alcohol consumption. SSM-Qualitative Research in Health, 2, 100152.

Herrin, M. A., Sherris, A. R., Dearborn, L. C., Loftus, C. T., Szpiro, A. A., Moore, P. E., Adgent, M. A., Barrett, E. S., Nguyen, R. H. N., & Carroll, K. N. (2023). Association between maternal occupational exposure to cleaning chemicals during pregnancy and childhood wheeze and asthma. Frontiers in Epidemiology, 3, 1166174.

Herzog-Petropaki, N., Derksen, C., & Lippke, S. (2022). Health behaviors and behavior change during pregnancy: Theory-based investigation of predictors and interrelations. Sexes, 3(3), 351-366.

Irani, M., Khadivzadeh, T., Asghari-Nekah, S.-M., & Ebrahimipour, H. (2019). Coping strategies of pregnant women with detected fetal anomalies in Iran: A qualitative study. Iranian Journal of Nursing and Midwifery Research, 24(3), 227-233.

Jevsnik, M., Cesen, A., Santic, M., & Ovca, A. (2021). Food safety knowledge and practices of pregnant women and postpartum mothers in Slovenia. Foods, 10(10), 2412.

Lacerda, R. H. W., Furtado, P. G. C., & Vieira, A. R. (2021). Maternal smoking leads to larger cleft palate defects. Frontiers in Dental Medicine, 1, 632037.

Lambert, V. A., & Lambert, C. E. (2012). Qualitative descriptive research: An acceptable design. Pacific Rim International Journal of Nursing Research, 16(4), 255-256.

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. California: Sage Publications.

Molina-Mesa, S., Martínez-Cendán, J. P., Moyano-Rubiales, D., Cubillas-Rodríguez, I., Molina-García, J., & González-Mesa, E. (2022). Detection of relevant heavy metal concentrations in human placental tissue: Relationship between the concentrations of Hg, As, Pb and Cd and the diet of the pregnant woman. International Journal of Environmental Research and Public Health, 19(22), 14731.

Mondal, D., Mwale, T., Xu, L., Matthews, H., Oyeka, A., Lace-Costigan, G., & Polya, D. A. (2019). Risk perception of arsenic exposure from rice intake in a UK population. Palgrave Communications, 5(1), 1-7.

National Institute for Occupational Safety and Health. (2023). Learn about specific exposures during pregnancy & breastfeeding. Centers for Disease Control and Prevention.

National Institute of Child Development. (2020). Situations of early childhood development.

National Statistical Office. (2023). Health statistics.

Nuampa, S., Tangsuksan, P., Chunpia, C., & Wanasathit, W. (2020). Experiences of antenatal care attendance and health information seeking among working pregnancy in the large industry: Descriptive qualitative study. Nursing Science Journal of Thailand, 38(4), 44-61.

Obajimi, G. O. (2019). Health information-seeking behaviour of pregnant women at the University College Hospital, Ibadan, Nigeria. African Journal of Medicine and Medical Sciences, 48(2), 191-198.

Oktalia, J. (2023). Behavior of pregnant women toward environmental exposure tobacco smoke. International Journal of Science and Society, 5(2), 326-335.

Onchoi, C., Kongtip, P., Nankongnab, N., Chantanakul, S., Sujirarat, D., & Woskie, S. (2020). Organophosphates in meconium of newborn babies whose mothers resided in agricultural areas of Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health, 51(1), 77-87.

Reis, J., Spencer, P. S., Román, G. C., & Buguet, A. (2021). Environmental neurology in the tropics. Journal of the Neurological Sciences, 421, 117287.

Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing & Health, 23(4), 334-340.;2-G

Sauvant-Rochat, M., Kouame, N. G. L., Fradet, M. R., Marie, C., Bernard, L., Maquinghen, S., Lémery, D., & Vendittelli, F. (2019). Cosmetics and pregnancy: Perception of health risk by health professionals and pregnant women. European Journal of Public Health, 29(Supplement_4), ckz186-141.

Schaefer, A. M., Zoffer, M., Yrastorza, L., Pearlman, D. M., Bossart, G. D., Stoessel, R., & Reif, J. S. (2019). Mercury exposure, fish consumption, and perceived risk among pregnant women in coastal Florida. International Journal of Environmental Research and Public Health, 16(24), 4903.

Soltani, F., Barzegar, F., Sangestani, G., Roshanaii, G., & Maleki, A. (2019). The effectiveness of family counselling on reducing exposure to secondhand smoke at home among pregnant women in Iran. Tobacco Prevention & Cessation, 5, 41.

Stotland, N. E., Sutton, P., Trowbridge, J., Atchley, D. S., Conry, J., Trasande, L., Gerbert, B., Charlesworth, A., & Woodruff, T. J. (2014). Counseling patients on preventing prenatal environmental exposures-a mixed-methods study of obstetricians. PloS One, 9(6), e98771.

Sun, L., Wu, Q., Wang, H., Liu, J., Shao, Y., Xu, R., Gong, T., Peng, X., & Zhang, B. (2023). Maternal exposure to ambient air pollution and risk of congenital heart defects in Suzhou, China. Frontiers in Public Health, 10, 1017644.

Swanson, J. (2023). Inpatient hospitalization costs associated with birth defects among persons aged <65 years—United States, 2019. MMWR Morbidity and Mortality Weekly Report, 72, 739-745.

Sychareun, V., Phounsavath, P., Sihavong, A., Kounnavong, S., Chaleunvong, K., Machowska, A., Keohavong, B., Mayxay, M., Eriksen, J., & Hanson, C. (2022). Perceptions and reported practices of pregnant women and mothers of children under two years of age regarding antibiotic use and resistance in Vientiane province, Lao PDR: A qualitative study. BMC Pregnancy and Childbirth, 22, 569.

Teysseire, R., Lecourt, M., Canet, J., Manangama, G., Sentilhes, L., & Delva, F. (2019). Perception of environmental risks and behavioral changes during pregnancy: A cross-sectional study of French postpartum women. International Journal of Environmental Research and Public Health, 16(4), 565.

Thammarat, R., Polprasarn, P., & Jantasuwan, R. (2020). Knowledge and safe consumption behavior of vegetables and fruit from pesticides and serum cholinesterase levels in pregnant women, Nakhon Si Thammarat Province. Royal Thai Navy Medical Journal, 47(3), 660-672.

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349-357.

US Food and Drug Administration. (2022). Food safety for pregnant women, their unborn babies, and children under five.

Waeyeng, D., Khamphaya, T., Pouyfung, P., Vattanasit, U., & Yimthiang, S. (2022). Blood lead levels among non-occupationally exposed pregnant women in Southern Thailand. Toxics, 10(10), 599.

World Health Organization. (2022). Congenital disorders.

Yadav, D., Rangabhashiyam, S., Verma, P., Singh, P., Devi, P., Kumar, P., Hussain, C. M., Gaurav, G. K., & Kumar, K. S. (2021). Environmental and health impacts of contaminants of emerging concerns: Recent treatment challenges and approaches. Chemosphere, 272, 129492.

Yavagal, P. C., Velangi, C. S., Desai, J. M., Gupta, H., Sheik, F. S., & Kaushal, M. (2021). Knowledge, attitude, and behavior related to secondhand smoke exposure among pregnant women with smoking spouses in Davangere City: A cross-sectional survey. Journal of Indian Association of Public Health Dentistry, 19(1), 37-41.

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