To see or not to see? Midwives' perceptions of reduced antenatal attendances for ‘low-risk’ women

Sanders, Julia; Somerset, Maggie; Jewell, David; Sharp, Deborah

doi:10.1054/midw.1999.0183

Cited by 16 publications

(40 citation statements)

References 8 publications

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“…The number of antenatal attendances is reported as a measure of process and not of outcome. The process was also assessed by a focus group study of the midwives involved in the conduct of the trial and has been reported elsewhere 12 .…”

Section: Methodsmentioning

confidence: 99%

A randomised controlled trial of flexibility in routine antenatal care

Jewell

Sharp

Sanders

et al. 2000

BJOG

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Objective To assess changes in satisfaction associated with a flexible approach to antenatal care schedDesign Randomised controlled trial.Setting Eleven primary care centres providing midwifery care in Avon.Participants Six hundred and nine women at low risk of obstetric complications presenting for antenatal care.Methods A standard antenatal care schedule ('traditional care') was compared with a schedule based on a minimum number of visits and additional visits with timing agreed between women and midwives ('flexible care').Main outcome measures Women's attitudes to pregnancy and motherhood using a subscale of the Maternal Adjustment and Maternal Attitudes scale, satisfaction with antenatal care, and perception of the speed of recognition of antenatal complications.Results There was no difference between the two groups in terms of attitudes to pregnancy and motherhood (mean difference on Maternal Adjustment and Maternal Attitudes scale -0.64,95% CI -1.39 to 0.1 1, P = 0.068) and no difference in the proportions of women reporting antenatal problems as soon as possible (traditional group 74-5%, flexible group 76.4%, difference -2%, 95% CI -12.1 to 8.2, P = 0.70). Women receiving traditional care reported higher levels of satisfaction for the care provided by community midwives (P c 0.01). Women receiving flexible care were more likely to report having a choice over the number and timing of their antenatal visits ( P < 0401), but were also more likely to report that they would like to have been seen more often (P < 0.01). There was no difference between the groups in rates of obstetric complications.Conclusions An imposed reduction in antenatal visits has been reported to increase dissatisfaction in other studies. In this study, encouraging women to adopt a flexible approach to antenatal care resulted in a similar finding. Successful implementation of such approaches may depend on more careful selection of women who welcome such an approach, more encouragement to pregnant women to express their own needs and greater feelings of commitment on the part of the care providers.ules offered to women at low obstetric risk.

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Section: Methodsmentioning

confidence: 99%

A randomised controlled trial of flexibility in routine antenatal care

Jewell

Sharp

Sanders

et al. 2000

BJOG

Self Cite

View full text Add to dashboard Cite

show abstract

“…Women make fewer visits [4] but still receive health promotion, screening, detection and treatment of problems, prevention of diseases, complications and birth preparedness [10]. Concerns have been raised by women and service providers that the fewer visits would result in adverse maternal and foetal outcomes [12][13][14]. Villar [9] in a multicenter study that involved 12,568 women in the new model arm and 11,958 in the standard care arm showed that there was really no statistically significant difference in adverse maternal and foetal outcomes in women who received traditional care and focused antenatal care.…”

Section: Introductionmentioning

confidence: 99%

Acceptability of focused antenatal care by antenatal clinic attendees in Obio Cottage Hospital, Port Harcourt, Nigeria

Ekott¹,

Edet²,

Ovwigho³

et al. 2017

Res J of Womens Health

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Introduction: Focused antenatal care (FANC), based on fewer goal-oriented visits, is the WHO's recommended care for pregnant women. The objectives of the study were to assess the acceptability of FANC and barriers to its implementation at the hospital. Methodology: This was a cross-sectional study conducted among antenatal clinic attendees between January and March 2011 at Obio Cottage Hospital, Port Harcourt Nigeria. Women were recruited by systematic sampling technique into the study. Questionnaires which sought demographic data, acceptability or rejection of fewer antenatal visits and reasons for decisions were administered to them. Data analysis was performed using Stata 10. Logistic regression analysis was performed to determine associations between demographic parameters and acceptance of FANC. Significance level was set at P<0.05. Results: The analysis was based on 456 out of 500 completed questionnaires. The mean age and parity of the women were 28.6±4.2 and 1±1 respectively. The mean number of preferred visits was 13.4±6.9 visits, (IQR 9-18). Reduced visits were acceptable to 75% of the women. The main reason for accepting reduced visits was to save time 164 (40.6%). The main reasons for rejecting reduced visits were for better monitoring of pregnancy (35.1%) and early detection of problems (21.6%). The likelihood of accepting fewer visits increased with age. OR=1.04; 95% CI (1.09-1.10), P=0.01. Conclusion: Focused antenatal care was acceptable to most women in the clinic. The concern it would compromise monitoring of pregnancy should be addressed during health education.

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“…In this respect, the performance constitutes a form of flattery and a mirroring of these elite models -an educational method widely advocated for early modern girls. 50 It potentially functions as a form of training in the behaviour of the courtly lady and as a means of seeking a position in the court. The girls, for the most part, follow the practices of Anna in taking the dancing roles of masquers but with some differences.…”

Section: Performing Girls: Cupid's Banishmentmentioning

confidence: 99%

“Shall we playe the good girles”: Playing Girls, Performing Girlhood on Early Modern Stages

Lamb

2016

Renaissance Drama

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To see or not to see? Midwives' perceptions of reduced antenatal attendances for ‘low-risk’ women

Cited by 16 publications

References 8 publications

A randomised controlled trial of flexibility in routine antenatal care

A randomised controlled trial of flexibility in routine antenatal care

Acceptability of focused antenatal care by antenatal clinic attendees in Obio Cottage Hospital, Port Harcourt, Nigeria

“Shall we playe the good girles”: Playing Girls, Performing Girlhood on Early Modern Stages

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