Better together: A qualitative exploration of women’s perceptions and experiences of group antenatal care

Abstract

O. ORCID: 0000-0003-4890-9435, Rayment, J., Haora, P., Wiggins, M. and Harden, A. (2019). Better together: a qualitative exploration of women's perceptions and experiences of group antenatal care. ABSTRACTProblem: Childbearing women from socio-economically disadvantaged communities and minority ethnic groups are less likely to access antenatal care and experience more adverse pregnancy outcomes.Background: Group antenatal care aims to facilitate information sharing and social support. It is associated with higher rates of attendance and improved health outcomes.Aims: To assess the acceptability of a bespoke model of group antenatal care (Pregnancy Circles) in an inner city community in England, understand how the model affects women's experiences of pregnancy and antenatal care, and inform further development and testing of the model. Methods:A two-stage qualitative study comprising focus groups with twenty six local women, followed by the implementation of four Pregnancy Circles attended by twenty four women, which were evaluated using observations, focus groups and semi-structured interviews with participants.Data were analysed thematically. Findings: Pregnancy Circles offered an appealing alternative to standard antenatal care and functioned as an instrument of empowerment, mediated through increased learning and knowledge sharing, active participation in care and peer and professional relationship building. Multiparous women and women from diverse cultures sharing their experiences during Circle sessions was particularly valued. Participants had mixed views about including partners in the sessions.Conclusions: Group antenatal care, in the form of Pregnancy Circles, is acceptable to women and appears to enhance their experiences of pregnancy. Further work needs to be done both to test the findings in larger, quantitative studies and to find a model of care that is acceptable to women and their partners.

Women’s experiences of decision-making and informed choice about pregnancy and birth care: a systematic review and meta-synthesis of qualitative research

“…In thinking of solutions, it is more important than ever to embrace emergent models in maternity, like midwifery-led care, continuity of carer or group antenatal care [83], which support more fluid decisionmaking, break down dichotomies and facilitate the social network effect [84,85]. However, given the slow development of these models in health systems and comparatively low uptake of 'alternative' options among women, even in countries with strong policy and midwifery integration [86], there is still significant work to be done on normalising these pathways.…”

Group antenatal care (Pregnancy Circles) for diverse and disadvantaged women: study protocol for a randomised controlled trial with integral process and economic evaluations

“…The group approach encourages women to engage in self-monitoring (i.e. checking their own urine and blood pressure) with the aim of increasing their knowledge and confidence [4]. In pregnancy, an increased sense of autonomy and wider choice have been linked to a sense of greater control around birthing, which in turn can increase women's satisfaction with giving birth.…”

“…This study is part of a NIHR-funded Programme Grant for Applied Research, the REACH Pregnancy Programme (Reference RP-DG-1108-10,049), which aims to improve women's access to, engagement with, and experience of antenatal care. The Programme comprises four main components including this trial and a two-stage feasibility/pilot study preceding it [4,21,23].…”

“…Furthermore, delivery of group antenatal care to vulnerable groups [10] has been shown to be successful, with evidence of possible improved outcomes for specific groups. Qualitative studies have also indicated potential added advantages arising from having a mixed group of participants [4].…”

“…Traditional antenatal care, delivered by midwives, is on a one-to-one basis, but antenatal care delivered by midwives on a group basis, has been implemented in several countries with some success. Examples include in the UK [ 4 ], Australia [ 5 ], the US [ 6 ], Iran [ 7 ] and elsewhere. Evidence on group care shows increased women’s satisfaction [ 7 , 8 ] as well as potential better health and safety outcomes [ 6 , 8 , 9 ].…”