A qualitative descriptive study of the group prenatal care experience: perceptions of women with low-risk pregnancies and their midwives

BMC Pregnancy and Childbirth

Anne B Biringer¹  Leyla E Eryuzlu²  Wendy Sword⁴  Sarah D McDonald³ 

[1] Department of Family and Community Medicine, University of Toronto, 60 Murray Street, Fourth floor, Toronto, Ontario M5T 3L9, Canada;Faculty of Health Sciences, McMaster University, 1280 Main St. West, Hamilton, Ontario L8S4K1, Canada;Departments of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main St. West, HSC 3N52B, Hamilton, Ontario L8S4K1, Canada;School of Nursing, McMaster University, 1280 Main St. West, Hamilton, Ontario L8S 4K1, Canada

关键词: Qualitative research;    Experience;    Satisfaction;    Midwives;    Pregnant women;    Group prenatal care;   

Others  :  1125445
DOI  :  10.1186/1471-2393-14-334

 received in 2014-05-07, accepted in 2014-09-23,  发布年份 2014

【 摘 要 】

Background

Group prenatal care (GPC) originated in 1994 as an innovative model of prenatal care delivery. In GPC, eight to twelve pregnant women of similar gestational age meet with a health care provider to receive their prenatal check-up and education in a group setting. GPC offers significant health benefits in comparison to traditional, one-on-one prenatal care. Women in GPC actively engage in their healthcare and experience a supportive network with one another. The purpose of this study was to better understand the GPC experience of women and care providers in a lower risk group of women than often has been previously studied.

Methods

This qualitative descriptive study collected data through three focus group interviews - two with women who had completed GPC at a midwifery clinic in Ontario, Canada and one with the midwives at the clinic. Data was analyzed through open coding to identify themes.

Results

Nine women and five midwives participated in the focus groups, from which eight categories as well as further subcategories were identified: The women and midwives noted reasons for participating (connections, education, efficiency). Participants suggested both benefits (learning from the group, normalizing the pregnancy experience, preparedness for labour and delivery, and improved relationships as all contributing to positive health outcomes) and concerns with GPC (e.g. sufficient time with the midwife) which generally diminished with experience. Suggestions for change focused on content, environment, partners, and access to the midwives. Challenges to providing GPC included scheduling and systems-level issues such as funding and regulation. Flexibility and commitment to the model facilitated it. Comparison with other models of care identified less of a relationship with the midwife, but more information received. In promoting GPC, women would emphasize the philosophy of care to other women and the midwives would promote the reduction in workload and women’s independence to colleagues.

Conclusions

Overall, women and midwives expressed a high level of satisfaction with their GPC experience. This study gained insight into previously unexplored areas of the GPC experience, perceptions of processes that contribute to positive health outcomes, strategies to promote GPC and elements that enhance the feasibility of GPC.

【 授权许可】

   
2014 McDonald et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Alexander GR, Kotelchuck M: Assessing the role and effectiveness of prenatal care: history, challenges, and directions for future research. Public Health Rep 2001, 116:306-316.
• [2]Novick G: CenteringPregnancy and the current state of prenatal care. J Midwifery Womens Health 2004, 49:405-411.
• [3]Rising SS: Centering pregnancy. An interdisciplinary model of empowerment. J Nurse Midwifery 1998, 43:46-54.
• [4]Kirkham C, Harris S, Grzybowski S: Evidence-based prenatal care: Part I. General prenatal care and counseling issues. Am Fam Physician 2005, 71:1307-1316.
• [5]Walker DS, Worrell R: Promoting healthy pregnancies through perinatal groups: a comparison of CenteringPregnancy(R) group prenatal care and childbirth education classes. J Perinat Educ 2008, 17:27-34.
• [6]Centering Healthcare Institute: The Centering Model. Accessed at http://www.centeringhealthcare.org/pages/about/history.php webcite on March 31, 2014. 2014. Ref Type: Online Source
• [7]Massey Z, Rising SS, Ickovics J: CenteringPregnancy group prenatal care: promoting relationship-centered care. J Obstet Gynecol Neonatal Nurs 2006, 35:286-294.
• [8]Ruiz-Mirazo E, Lopez-Yarto M, McDonald SD: Group prenatal care versus individual prenatal care: a systematic review and meta-analyses. J Obstet Gynaecol Can 2012, 34:223-229.
• [9]Ickovics JR, Kershaw TS, Westdahl C, Magriples U, Massey Z, Reynolds H, Rising SS: Group prenatal care and perinatal outcomes: a randomized controlled trial. Obstet Gynecol 2007, 110:330-339.
• [10]McNeil DA, Vekved M, Dolan SM, Siever J, Horn S, Tough SC: Getting more than they realized they needed: a qualitative study of women’s experience of group prenatal care. BMC Pregnancy Childbirth 2012, 12:17. BioMed Central Full Text
• [11]McNeil DA, Vekved M, Dolan SM, Siever J, Horn S, Tough SC: A qualitative study of the experience of CenteringPregnancy group prenatal care for physicians. BMC Pregnancy Childbirth 2013, 13(Suppl 1):S6. BioMed Central Full Text
• [12]Shields SG, Candib LM: Women-Centered Care in Pregnancy and Childbirth. Abingdon: Radcliffe Publishing; 2010.
• [13]Baldwin K, Phillips G: Voices along the journey: midwives’ perceptions of implementing the CenteringPregnancy model of prenatal care. J Perinat Educ 2011, 20:210-217.
• [14]Fereday J, Collins C, Turnbull D, Pincombe J, Oster C: An evaluation of midwifery group practice. Part II: women’s satisfaction. Women Birth 2009, 22:11-16.
• [15]Kennedy HP, Farrell T, Paden R, Hill S, Jolivet R, Willetts J, Rising SS: “I wasn’t alone”–a study of group prenatal care in the military. J Midwifery Womens Health 2009, 54:176-183.
• [16]Andersson E, Christensson K, Hildingsson I: Parents’ experiences and perceptions of group-based antenatal care in four clinics in Sweden. Midwifery 2012, 28:502-508.
• [17]Novick G, Sadler LS, Kennedy HP, Cohen SS, Groce NE, Knafl KA: Women’s experience of group prenatal care. Qual Health Res 2011, 21:97-116.
• [18]Sandelowski M: Whatever happened to qualitative description? Res Nurs Health 2000, 23:334-340.
• [19]Patton MQ: Qualitative Research & Evaluation Methods (3rd Edition). 3rd edition. Thousand Oaks: Sage Publications; 2002.
• [20]Teate A, Leap N, Homer CS: Midwives’ experiences of becoming CenteringPregnancy facilitators: a pilot study in Sydney, Australia. Women Birth 2013, 26:e31-e36.