‘It's something you have to put up with’—service users’ experiences of in utero transfer: a qualitative study

Abstract

Objective The purpose of this study was to gain in-depth insight and enhance understanding of service users' experiences of the in utero transfer (IUT) process, in order to inform policy and improve the current service provision of maternal care.Design Qualitative descriptive study using semi-structured interviews.Setting Participant's home or hospital in the Midlands, UK.Population Fifteen women transferred in utero to a tertiary level maternity hospital; five male partners and two grandmothers.Methods Audio-recorded individual or paired semi-structured interviews transcribed verbatum and analysed thematically using NVIVO 9.Main outcome measures Facilitators and barriers of the IUT experience.Results Findings suggest that IUT is an emotional experience that financially disadvantages patients and their families. Male partners were perceived to be most negatively affected by the experience. The quality of the IUT experience was influenced by a range of factors, including the lack of proximity to home and the lack of information. Patients had little knowledge or awareness of IUT, and most felt unprepared for displacement. Despite this, there was resigned acceptance that IUT was a necessary rather than adverse experience.Conclusions The experience of IUT for service users could be enhanced by ensuring that they are better informed about the process and the circumstances that necessitate displacement, that they are better informed about the hospital to which they are being transferred, and that they are transferred as close to home as possible. Efforts to minimise the emotional and socio-economic impact of IUT on women and their families also need to be considered.

All the right moves: why in utero transfer is both important for the baby and difficult to achieve and new strategies for change

“…However, transfers before birth are also associated with emotional and financial burden upon the women and their families because of longer travel distances between home and their newborn. Broadly, women recognise the importance of in utero transfer and find it acceptable 15,38 . However, the unplanned relocation to unfamiliar surroundings at an already stressful time in the pregnancy creates anxiety, shock, and worry 38 .…”

“…Broadly, women recognise the importance of in utero transfer and find it acceptable 15,38 . However, the unplanned relocation to unfamiliar surroundings at an already stressful time in the pregnancy creates anxiety, shock, and worry 38 . The emotional and financial burden of in utero transfers upon women and their families is beginning to be explored in the literature, such as the following description of a woman who was transferred from her home hospital because of capacity issues: Pregnant women value choice of birth place and continuity of care as important aspects of their care 39 , and in utero transfer can feel like the antithesis of this.…”

Threatened preterm labour: Women's experiences of risk and care management: A qualitative study

“…Vis et al (2011) undertook a systematic review of papers assessing the additional effects (such as reassurance) of cervical length measurement in threatened preterm labour but did not find a single study that had measured the psychosocial effects. One study described women's experiences of in utero transfer (IUT) and how, despite little knowledge of IUT and feelings of unpreparedness, most women were resigned to the intervention (Porcellato et al, 2015). No studies were found on women's experience of antenatal corticosteroid use, one of the most common interventions for women with TPTL symptoms (Roberts et al, 2017).…”

Extreme preterm birth in the right place: a quality improvement project

“…On a wider scale, however, transfer is highly likely to be cost-effective. Negative parental experience of IUT14 should be set against experience of postnatal transfer 15. There are limitations to this report.…”