Referral and attendance at a specialist antenatal clinic: qualitative study of women’s views

Abstract

Objective To explore women's views on being referred to and attending a specialist antenatal hypertension clinic.Design Qualitative interview study.Setting A pregnancy hypertension clinic in a large teaching hospital in the East Midlands.Population Twenty-one women (aged 18 years and above) attending the pregnancy hypertension clinic for the first time during their current pregnancy.Methods Women who had been referred to and attended a specialist antenatal clinic participated in semi-structured interviews. Data analysis was based on the constant comparative method.Main outcome measures Women's experiences and perceptions of being referred to and attending a specialist antenatal clinic.Results Being referred to the clinic conferred an 'at risk' status on women. Some women welcomed the referral but others experienced it as unsettling. Many were unclear about why they had been identified as being at risk or had difficulties in accepting the legitimacy of the reason for referral. Women were often inadequately informed about why they were referred to the clinic, what they could expect and the benefits of attending the clinic over management in the community. Although attendance at the clinic was cited as a source of reassurance, the reassurance was often made necessary by concern raised by the initial referral.Conclusions Women's accounts suggest that the interface between community and secondary antenatal services needs improvement to minimise possible adverse effects from identifying women as being 'at risk' during pregnancy.Keywords Antenatal clinic, qualitative, women's views.Please cite this paper as: Jackson C, Bosio P, Habiba M, Waugh J, Kamal P, Dixon-Woods M. Referral and attendance at a specialist antenatal clinic: qualitative study of women 's views. BJOG 2006; 113:909-913.

Remembering and repeating childhood dental treatment experiences: parents, their children, and barriers to dental care

“…Jackson et al. ’s 23 qualitative study of women’s attendance at ante‐natal clinic showed that the mothers found accessing the clinic as anxiety‐provoking and ‘distressing’. Moreover, in this study, the parents’ did not wish their own fears to be communicated to their children 24 and this may have contributed to their view that they were not candidates for dentistry.…”

Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review

“…Providers' behaviour is considered influenceable via, for example, education [97,[119][120][121], and guidelines [19,97,115,122]. Women bring in factors such as timing of presentation, sense of control, views and beliefs, sense of safety, perceived norms, perceived availability of options, and demographic characteristics such as age, level of educational and income [114,115,[123][124][125][126][127][128][129][130]. Because a consulting care provider either needs additional resources or does not, the decision to refer is inherently a "threshold phenomenon" [108].…”

Specialised antenatal clinics for women with a pregnancy at high risk of preterm birth (excluding multiple pregnancy) to improve maternal and infant outcomes

“…However, the trials included in the review included no information on psychological outcomes for women. Some studies have suggested that whilst some pregnant women welcome referral to a specialist clinic during pregnancy, others experience it as unsettling (Jackson 2006). Any future research in this area should examine which aspects of service provision are preferred by women.…”

“…The package of care offered in such clinics may include promising prophylactic interventions for labour prevention including progesterone, clindamycin or cervical cerclage (Althuisius 1998; Da Fonesca 2003; Ugwumadu 2003). However, stress has been associated with enhanced risk of preterm delivery and there is evidence that, whilst some pregnant women welcome referral to a specialist clinic during pregnancy, others experience it as unsettling (Jackson 2006).…”