Perceptions of Significance Regarding Prenatal Care Among Multiparous Patients

Saturday, 21 April 2018: 11:50 AM

Susan E. Wurzer Gustafson, EdD, MSN, RN
School of Nursing, Elmira College, Pine City, NY, USA

Abstract

Pregnancy, with the inherent need for prenatal care, is a global condition. Research has demonstrated a positive relationship between maternal adherence to prenatal care with associated maternal, fetal, and delivery outcomes of pregnancy. Non-adherence has been shown to increase risks of maternal and fetal morbidity and mortality. Despite the importance of care, maternal adherence to prenatal care is problematic, pervasive, and persists without an identified etiology. Research to identify a causation for maternal nonadherence has focused upon groups of women with shared traits or circumstance as a predisposing risk. The aim of this study was to identify how adherent multiparous patients perceive the significance or value of prenatal care. Participants were recruited from a convenience sample as they presented to an obstetric practice in Upstate New York, based inclusion criteria. Maternal multiparous patients who consented to participate, who were in the first trimester of pregnancy, and who had not experienced a loss of pregnancy, were interviewed over an eleven week period. A qualitative semi-structured research study, utilizing a directed content approach with the Health Belief Model as a theoretical base, indicated five themes with an overarching theme of Maternal Fetal (M-F) attachment, as motivating cues to action in seeking care. The maternal patients in this study were all found to have established M-F attachment, prompting them to seek care. Liitations of the study included a small sample size and homogenous sampling of those meeting criteria. Understanding the importance of M-F attachment, and the way in which individual maternal needs may be met throughout pregnancy, has the potential for improved practice aimed at increasing adherence rates. Further research is indicated to explore the multifactorial origins of established M-F attachment, and ways to deliver patient centered-care in practice to meet the diverse and changing needs of maternal patients. The ultimate goal for practice is to improve maternal adherence rates, subsequently affecting improved maternal, fetal, and delivery outcomes.