Prenatal care: the patient's perspective. A qualitative study

• Published in: Prenatal diagnosis 2006-10, Vol.26 (10), p.931-937
• Main Authors: Leithner, Katharina, Assem-Hilger, Eva, Fischer-Kern, Melitta, Löffler-Stastka, Henriette, Thien, Ralf, Ponocny-Seliger, Elisabeth
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adolescent; Adult; Attitude of Health Personnel; Biological and medical sciences; Delivery. Postpartum. Lactation; Female; Gynecology. Andrology. Obstetrics; health professionals; Humans; Management. Prenatal diagnosis; Medical sciences; obstetrics; Parity; Patient Satisfaction; Physician-Patient Relations; Pregnancy; Pregnancy Complications - psychology; Pregnancy. Fetus. Placenta; Prenatal Care; prenatal diagnosis; Prenatal Diagnosis - psychology; psychological support; qualitative content analysis; Qualitative Research
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.1529

Objectives To investigate the subjective experiences and perceptions of the prenatal care system for women following a prenatal diagnosis and to assess the factors related to dissatisfaction with medical treatment. Methods Data derived from a follow‐up investigation in fifty women following a prenatal diagnosis is presented. Women were asked to give written comments concerning their feelings and experiences during their time at the prenatal care unit. A qualitative content analysis was performed in order to examine the patients' perceptions and expectations of the prenatal care management and to seek potential associations of certain attitudes with socio‐demographic, clinical, or psychological characteristics. Womens' comments were coded within established categories including ‘satisfaction’, ‘dissatisfaction’ and ‘communicated emotionality’. Results A high proportion of women were found to be dissatisfied with the physicians' attitudes (42%), the amount of information provided (46%), and medical staffs' attitudes (30%). One criticism, in particular, concerned a lack of communication skills in doctors and medical staff members. Forty‐eight percent of our study population mentioned that they had benefited from psychological support. ‘Nullipara’ was the only variable associated with dissatisfaction with the received prenatal care. Conclusions The results of the study suggest that the high degree of discontent found in prenatal care patients could at least in some part be alleviated by implementation of communication training and supervision services for prenatal care workers. Moreover, nullipara may constitute a particular vulnerable subgroup that may need special attention and support. However, given the qualitative nature of our study, our results warrant replication in further empirically based research. Copyright © 2006 John Wiley & Sons, Ltd.