Timing of the initiation of antenatal care: An exploratory qualitative study of women and service providers in East London
| Autor: | Angela Harden, Adrian Renton, Meg Wiggins, Joanne Morris, Bethan Hatherall, Farah Jamal, Lorna Sweeney, Inderjeet Kaur |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Time Factors Urban Population Antenatal care Prenatal care Midwifery Article Health Services Accessibility 03 medical and health sciences 0302 clinical medicine Nursing Pregnancy Obstetrics and Gynaecology London Maternity and Midwifery Developed countries Humans Medicine Maternal Health Services 030212 general & internal medicine Qualitative Research 030219 obstetrics & reproductive medicine business.industry Obstetrics and Gynecology Prenatal Care Focus Groups Patient Acceptance of Health Care Service provider medicine.disease Focus group Access to health care East london Female Perception Pregnant Women business human activities Developed country Qualitative research |
| Zdroj: | Midwifery |
| ISSN: | 0266-6138 |
| DOI: | 10.1016/j.midw.2016.02.017 |
| Popis: | Objective to explore the factors which influence the timing of the initiation of a package of publically-funded antenatal care for pregnant women living in a diverse urban setting Design a qualitative study involving thematic analysis of 21 individual interviews and six focus group discussions. Setting Newham, a culturally diverse borough in East London, UK Participants individual interviews were conducted with 21 pregnant and postnatal women and focus group discussions were conducted with a total of 26 health service staff members(midwives and bilingual health advocates) and 32 women from four community groups (Bangladeshi, Somali, Lithuanian and Polish). Findings initial care-seeking by pregnant women is influenced by the perception that the package of antenatal care offered by the National Health Service is for viable and continuing pregnancies, as well as little perceived urgency in initiating antenatal care. This is particularly true when set against competing responsibilities and commitments in women’s lives and for pregnancies with no apparent complications or disconcerting symptoms. Barriers to access to this package of antenatal care include difficulties in navigating the health service and referral system, which are compounded for women unable to speak English, and service provider delays in the processing of referrals. Accessing antenatal care was sometimes equated with relinquishing control, particularly for young women and women for whom language barriers prohibit active engagement with care. Conclusions and implications for practice if women are to be encouraged to seek antenatal care from maternity services early in pregnancy, the purpose and value to all women of doing so need to be made clear across the communities in which they live. As a woman may need time to accept her pregnancy and address other priorities in her life before seeking antenatal care, it is crucial that once she does decide to seek such care, access is quick and easy. Difficulties found in navigating the system of referral for antenatal care point to a need for improved access to primary care and a simple and efficient process of direct referral to antenatal care, alongside the delivery of antenatal care which is woman-centred and experienced as empowering. Highlights • Antenatal care provided by the maternity services is viewed as being specifically for viable and continuing pregnancies. • Antenatal care needs to be considered within the contexts of competing priorities in women’s lives. • Difficulties navigating the health service and referral system featured prominently as a barrier to initiating care. • For some women, receiving antenatal care equates to relinquishing control over their pregnancies. |
| Databáze: | OpenAIRE |
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