The views and anticipated needs of women in early pregnancy

Abstract

Objective To assess the expectations of antenatal care of pregnant women at the outset of pregnancy.Design Questionnaire study within a randomised controlled trial, comparing traditional antenatal careSetting Eleven primary care centres providing midwifery care in Avon.Population Five hundred and ninety-three pregnant women at low risk of obstetric complications presenting for antenatal care.Methods A questionnaire was completed by women who agreed to participate in the trial shortly after antenatal booking. The questionnaire explored women's views on their attitudes to pregnancy and antenatal care, the locus of control related to pregnancy, the planning of the pregnancy and expectations of care.Main outcome measures Comparisons between nulliparous and multiparous women in terms of their views of antenatal care, and their stated preference for a particular package of care.Results There was no difference in their views of pregnancy as an event entailing risk. On a locus of control scale that measured women's perceptions of factors which might affect their babies' health, nulliparous women rated antenatal care higher than multiparous women ( P = 0.OOOl). However, this was not associated with any difference between the two groups in their stated preference for traditional or flexible care. Approximately half of the women expressed no preference, and of those who did 61% would opt for traditional care. Almost one-fifth of the whole sample welcomed the idea of flexible care.Discussion These data support the evidence of previous studies that there remains a strong desire among pregnant women to receive a 'traditional' pattern of care, even among those who have previously experienced normal pregnancy. However, a minority can be identified at the outset of pregnancy who may welcome a change to a more flexible pattern of care.with a more flexible schedule.

Validation of the multidimensional health locus of control scales for labor and delivery

“…Primiparous women reported significantly lower Internal control expectancies than multiparous women, in contrast to previous research in which being primiparous was associated with higher Doctor HLC, but not lower Internal HLC (Jewell et al, 2000). Overall, research on how previous experience with childbirth is related to HLC beliefs is limited, and the findings reported here suggest that there may be important differences between primiparous and multiparous women that warrant further exploration.…”

“…There is some empirical evidence in the literature that supports this argument. In a cross‐sectional study, primiparous women attributed birth outcomes more to their healthcare providers and other people than did multiparous women (Jewell, Sanders, & Sharp, 2000). Although the authors did not identify differences in Internal or Chance HLC beliefs, it is likely that having experienced childbirth would be associated with higher Internal and lower Chance expectations of control.…”

Importance of patient pressure and perceived pressure and perceived medical need for investigations, referral, and prescribing in primary care: nested observational study

“…Errors are likely to be greater when patients' expectations are measured after consultation because patients prefer their management even if it was randomised 17. We therefore used measures of patient pressure or expectation before the consultation and doctors' perception of perceived pressure after the consultation, similar to established measures 8 – 10.…”

A Review of Prenatal Care Delivery to Inform the Michigan Plan for Appropriate Tailored Health Care in Pregnancy Panel

“…Similarly, all observational studies found similar maternal (eg, preterm birth, preeclampsia, psychological well-being) and neonatal outcomes (eg, low birth weight, low APGAR scores) between patient groups, though only two of the observational studies were sufficiently powered to detect differences. 16,17 Two studies with a total of 2,491 patients reported on patient experience with a reduced visit schedule: one RCT 18 and one observational study. 19 Study results were conflicting.…”