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Obstetrics and Gynecology Sep 2016To estimate the effect of group prenatal care on perinatal outcomes compared with traditional prenatal care. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To estimate the effect of group prenatal care on perinatal outcomes compared with traditional prenatal care.
DATA SOURCES
We searched MEDLINE through PubMed, EMBASE, Scopus, Cumulative Index of Nursing and Allied Health literature, the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov.
METHODS OF STUDY SELECTION
We searched electronic databases for randomized controlled trials and observational studies comparing group care with traditional prenatal care. The primary outcome was preterm birth. Secondary outcomes were low birth weight, neonatal intensive care unit admission, and breastfeeding initiation. Heterogeneity was assessed using the Q test and I statistic. Pooled relative risks (RRs) and weighted mean differences were calculated using random-effects models.
TABULATIONS, INTEGRATION, AND RESULTS
Four randomized controlled trials and 10 observational studies met inclusion criteria. The rate of preterm birth was not significantly different with group care compared with traditional care (11 studies: pooled rates 7.9% compared with 9.3%, pooled RR 0.87, 95% confidence interval [CI] 0.70-1.09). Group care was associated with a decreased rate of low birth weight overall (nine studies: pooled rate 7.5% group care compared with 9.5% traditional care; pooled RR 0.81, 95% CI 0.69-0.96), but not among randomized controlled trials (four studies: 7.9% group care compared with 8.7% traditional care, pooled RR 0.92, 95% CI 0.73-1.16). There were no significant differences in neonatal intensive care unit admission or breastfeeding initiation.
CONCLUSION
Available data suggest that women who participate in group care have similar rates of preterm birth, neonatal intensive care unit admission, and breastfeeding.
Topics: Adult; Breast Feeding; Female; Humans; Infant, Low Birth Weight; Infant, Newborn; Intensive Care Units, Neonatal; Observational Studies as Topic; Pregnancy; Pregnancy Outcome; Premature Birth; Prenatal Care; Randomized Controlled Trials as Topic; Young Adult
PubMed: 27500348
DOI: 10.1097/AOG.0000000000001560 -
Archives of Women's Mental Health Oct 2016Maternal prenatal stress is associated with preterm birth, intrauterine growth restriction, and developmental delay. However, the impact of prenatal stress on... (Review)
Review
Maternal prenatal stress is associated with preterm birth, intrauterine growth restriction, and developmental delay. However, the impact of prenatal stress on hemodynamics during pregnancy remains unclear. This systematic review was conducted in order to assess the quality of the evidence available to date regarding the relationship between prenatal stress and maternal-fetal hemodynamics. The PubMed/Medline, EMBASE, PsycINFO, Maternity and Infant Care, Trip, Cochrane Library, and CINAHL databases were searched using the search terms pregnancy; stress; fetus; blood; Doppler; ultrasound. Studies were eligible for inclusion if prenatal stress was assessed with standardized measures, hemodynamics was measured with Doppler ultrasound, and methods were adequately described. A specifically designed data extraction form was used. The methodological quality of included studies was assessed using well-accepted quality appraisal guidelines. Of 2532 studies reviewed, 12 met the criteria for inclusion. Six reported that prenatal stress significantly affects maternal or fetal hemodynamics; six found no significant association between maternal stress and circulation. Significant relationships between prenatal stress and uterine artery resistance (RI) and pulsatility (PI) indices, umbilical artery RI, PI, and systolic/diastolic ratio, fetal middle cerebral artery PI, cerebroplacental ratio, and umbilical vein volume blood flow were found. To date, there is limited evidence that prenatal stress is associated with changes in circulation. More carefully designed studies with larger sample sizes, repeated assessments across gestation, tighter control for confounding factors, and measures of pregnancy-specific stress will clarify this relationship.
Topics: Female; Hemodynamics; Humans; Pregnancy; Prenatal Care; Stress, Psychological
PubMed: 27329120
DOI: 10.1007/s00737-016-0645-1 -
The Cochrane Database of Systematic... Dec 2020Stillbirth is generally defined as a death prior to birth at or after 22 weeks' gestation. It remains a major public health concern globally. Antenatal interventions may... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Stillbirth is generally defined as a death prior to birth at or after 22 weeks' gestation. It remains a major public health concern globally. Antenatal interventions may reduce stillbirths and improve maternal and neonatal outcomes in settings with high rates of stillbirth. There are several key antenatal strategies that aim to prevent stillbirth including nutrition, and prevention and management of infections.
OBJECTIVES
To summarise the evidence from Cochrane systematic reviews on the effects of antenatal interventions for preventing stillbirth for low risk or unselected populations of women.
METHODS
We collaborated with Cochrane Pregnancy and Childbirth's Information Specialist to identify all their published reviews that specified or reported stillbirth; and we searched the Cochrane Database of Systematic Reviews (search date: 29 Feburary 2020) to identify reviews published within other Cochrane groups. The primary outcome measure was stillbirth but in the absence of stillbirth data, we used perinatal mortality (both stillbirth and death in the first week of life), fetal loss or fetal death as outcomes. Two review authors independently evaluated reviews for inclusion, extracted data and assessed quality of evidence using AMSTAR (A Measurement Tool to Assess Reviews) and GRADE tools. We assigned interventions to categories with graphic icons to classify the effectiveness of interventions as: clear evidence of benefit or harm; clear evidence of no effect or equivalence; possible benefit or harm; or unknown benefit or harm or no effect or equivalence.
MAIN RESULTS
We identified 43 Cochrane Reviews that included interventions in pregnant women with the potential for preventing stillbirth; all of the included reviews reported our primary outcome 'stillbirth' or in the absence of stillbirth, 'perinatal death' or 'fetal loss/fetal death'. AMSTAR quality was high in 40 reviews with scores ranging from 8 to 11 and moderate in three reviews with a score of 7. Nutrition interventions Clear evidence of benefit: balanced energy/protein supplementation versus no supplementation suggests a probable reduction in stillbirth (risk ratio (RR) 0.60, 95% confidence interval (CI) 0.39 to 0.94, 5 randomised controlled trials (RCTs), 3408 women; moderate-certainty evidence). Clear evidence of no effect or equivalence for stillbirth or perinatal death: vitamin A alone versus placebo or no treatment; and multiple micronutrients with iron and folic acid versus iron with or without folic acid. Unknown benefit or harm or no effect or equivalence: for all other nutrition interventions examined the effects were uncertain. Prevention and management of infections Possible benefit for fetal loss or death: insecticide-treated anti-malarial nets versus no nets (RR 0.67, 95% CI 0.47 to 0.97, 4 RCTs; low-certainty). Unknown evidence of no effect or equivalence: drugs for preventing malaria (stillbirth RR 1.02, 95% CI 0.76 to 1.36, 5 RCTs, 7130 women, moderate certainty in women of all parity; perinatal death RR 1.24, 95% CI 0.94 to 1.63, 4 RCTs, 5216 women, moderate-certainty in women of all parity). Prevention, detection and management of other morbidities Clear evidence of benefit: the following interventions suggest a reduction: midwife-led models of care in settings where the midwife is the primary healthcare provider particularly for low-risk pregnant women (overall fetal loss/neonatal death reduction RR 0.84, 95% CI 0.71 to 0.99, 13 RCTs, 17,561 women; high-certainty), training versus not training traditional birth attendants in rural populations of low- and middle-income countries (stillbirth reduction odds ratio (OR) 0.69, 95% CI 0.57 to 0.83, 1 RCT, 18,699 women, moderate-certainty; perinatal death reduction OR 0.70, 95% CI 0.59 to 0.83, 1 RCT, 18,699 women, moderate-certainty). Clear evidence of harm: a reduced number of antenatal care visits probably results in an increase in perinatal death (RR 1.14 95% CI 1.00 to 1.31, 5 RCTs, 56,431 women; moderate-certainty evidence). Clear evidence of no effect or equivalence: there was evidence of no effect in the risk of stillbirth/fetal loss or perinatal death for the following interventions and comparisons: psychosocial interventions; and providing case notes to women. Possible benefit: community-based intervention packages (including community support groups/women's groups, community mobilisation and home visitation, or training traditional birth attendants who made home visits) may result in a reduction of stillbirth (RR 0.81, 95% CI 0.73 to 0.91, 15 RCTs, 201,181 women; low-certainty) and perinatal death (RR 0.78, 95% CI 0.70 to 0.86, 17 RCTs, 282,327 women; low-certainty). Unknown benefit or harm or no effect or equivalence: the effects were uncertain for other interventions examined. Screening and management of fetal growth and well-being Clear evidence of benefit: computerised antenatal cardiotocography for assessing infant's well-being in utero compared with traditional antenatal cardiotocography (perinatal mortality reduction RR 0.20, 95% CI 0.04 to 0.88, 2 RCTs, 469 women; moderate-certainty). Unknown benefit or harm or no effect or equivalence: the effects were uncertain for other interventions examined.
AUTHORS' CONCLUSIONS
While most interventions were unable to demonstrate a clear effect in reducing stillbirth or perinatal death, several interventions suggested a clear benefit, such as balanced energy/protein supplements, midwife-led models of care, training versus not training traditional birth attendants, and antenatal cardiotocography. Possible benefits were also observed for insecticide-treated anti-malarial nets and community-based intervention packages, whereas a reduced number of antenatal care visits were shown to be harmful. However, there was variation in the effectiveness of interventions across different settings, indicating the need to carefully understand the context in which these interventions were tested. Further high-quality RCTs are needed to evaluate the effects of antenatal preventive interventions and which approaches are most effective to reduce the risk of stillbirth. Stillbirth (or fetal death), perinatal and neonatal death need to be reported separately in future RCTs of antenatal interventions to allow assessment of different interventions on these rare but important outcomes and they need to clearly define the target populations of women where the intervention is most likely to be of benefit. As the high burden of stillbirths occurs in low- and middle-income countries, further high-quality trials need to be conducted in these settings as a priority.
Topics: Cardiotocography; Female; Fetal Death; Fetal Development; Humans; Infant, Newborn; Insecticide-Treated Bednets; Midwifery; Nutrition Assessment; Perinatal Death; Pregnancy; Prenatal Care; Randomized Controlled Trials as Topic; Stillbirth; Systematic Reviews as Topic
PubMed: 33336827
DOI: 10.1002/14651858.CD009599.pub2 -
Nutrients Jan 2022The gut microbiota is a key factor in the correct development of the gastrointestinal immune system. Studies have found differences between the gut microbiota of...
The gut microbiota is a key factor in the correct development of the gastrointestinal immune system. Studies have found differences between the gut microbiota of newborns delivered by cesarean section compared to those vaginally delivered. Our objective was to evaluate the effect of ingestion of probiotics, prebiotics, or synbiotics during pregnancy and/or lactation on the development of the gut microbiota of the C-section newborns. We selected experimental studies in online databases from their inception to October 2021. Of the 83 records screened, 12 met the inclusion criteria. The probiotics used belonged to the genera , , , and , or a combination of those, with dosages varying between 2 × 10 and 9 × 10 CFU per day, and were consumed during pregnancy and/or lactation. Probiotic strains were combined with galacto-oligosaccharides, fructo-oligosaccharides, or bovine milk-derived oligosaccharides in the synbiotic formulas. Probiotic, prebiotic, and synbiotic interventions led to beneficial gut microbiota in cesarean-delivered newborns, closer to that in vaginally delivered newborns, especially regarding colonization. This effect was more evident in breastfed infants. The studies indicate that this beneficial effect is achieved when the interventions begin soon after birth, especially the restoration of bifidobacterial population. Changes in the infant microbial ecosystem due to the interventions seem to continue after the end of the intervention in most of the studies. More interventional studies are needed to elucidate the optimal synbiotic combinations and the most effective strains and doses for achieving the optimal gut microbiota colonization of C-section newborns.
Topics: Bifidobacterium; Breast Feeding; Cesarean Section; Ecosystem; Female; Gastrointestinal Microbiome; Humans; Infant, Newborn; Lactation; Lactobacillus; Male; Maternal Nutritional Physiological Phenomena; Prebiotics; Pregnancy; Prenatal Care; Probiotics; Synbiotics
PubMed: 35057522
DOI: 10.3390/nu14020341 -
BMC Psychiatry Feb 2015Prenatal depression can negatively affect the physical and mental health of both mother and fetus. The aim of this study was to determine the effectiveness of yoga as an... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Prenatal depression can negatively affect the physical and mental health of both mother and fetus. The aim of this study was to determine the effectiveness of yoga as an intervention in the management of prenatal depression.
METHODS
A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching PubMed, Embase, the Cochrane Library and PsycINFO from all retrieved articles describing such trials up to July 2014.
RESULTS
Six RCTs were identified in the systematic search. The sample consisted of 375 pregnant women, most of whom were between 20 and 40 years of age. The diagnoses of depression were determined by their scores on Structured Clinical Interview for DSM-IV and the Center for Epidemiological Studies Depression Scale. When compared with comparison groups (e.g., standard prenatal care, standard antenatal exercises, social support, etc.), the level of depression statistically significantly reduced in yoga groups (standardized mean difference [SMD], -0.59; 95% confidence interval [CI], -0.94 to -0.25; p = 0.0007). One subgroup analysis revealed that both the levels of depressive symptoms in prenatally depressed women (SMD, -0.46; CI, -0.90 to -0.03; p = 0.04) and non-depressed women (SMD, -0.87; CI, -1.22 to -0.52; p < 0.00001) were statistically significantly lower in yoga group than that in control group. There were two kinds of yoga: the physical-exercise-based yoga and integrated yoga, which, besides physical exercises, included pranayama, meditation or deep relaxation. Therefore, the other subgroup analysis was conducted to estimate effects of the two kinds of yoga on prenatal depression. The results showed that the level of depression was significantly decreased in the integrated yoga group (SMD, -0.79; CI, -1.07 to -0.51; p < 0.00001) but not significantly reduced in physical-exercise-based yoga group (SMD, -0.41; CI, -1.01 to -0.18; p = 0.17).
CONCLUSIONS
Prenatal yoga intervention in pregnant women may be effective in partly reducing depressive symptoms.
Topics: Depression; Exercise Therapy; Female; Humans; Pregnancy; Pregnancy Complications; Prenatal Care; Yoga
PubMed: 25652267
DOI: 10.1186/s12888-015-0393-1 -
Obstetrics and Gynecology Feb 2023To systematically review patient, partner or family, and clinician perspectives, preferences, and experiences related to prenatal care visit schedules and televisits for...
OBJECTIVE
To systematically review patient, partner or family, and clinician perspectives, preferences, and experiences related to prenatal care visit schedules and televisits for routine prenatal care.
DATA SOURCES
PubMed, the Cochrane databases, EMBASE, CINAHL, ClinicalTrials.gov , PsycINFO, and SocINDEX from inception through February 12, 2022.
METHODS OF STUDY SELECTION
This review of qualitative research is a subset of a larger review on both the qualitative experiences and quantitative benefits and harms of reduced prenatal care visit schedules and televisits for routine prenatal care that was produced by the Brown Evidence-based Practice Center for the Agency for Healthcare Research and Quality. For the qualitative review, we included qualitative research studies that examined perspectives, preferences, and experiences about the number of scheduled visits and about televisits for routine prenatal care.
TABULATION, INTEGRATION, AND RESULTS
We synthesized barriers and facilitators to the implementation of reduced care visits or of televisits into 1 of 14 domains defined by the Theoretical Domains Framework (TDF) and a Best Fit Framework approach. We summarized themes within TDF domains. We assessed our confidence in the summary statements using the GRADE-CERQual (Grading of Recommendations Assessment, Development and Evaluation-Confidence in Evidence from Reviews of Qualitative research) tool. Four studies addressed the number of scheduled routine prenatal visits, and five studies addressed televisits. Across studies, health care professionals believed fewer routine visits may be more convenient for patients and may increase clinic capacity to provide additional care for patients with high-risk pregnancies. However, both patients and clinicians had concerns about potential lesser care with fewer visits, including concerns about quality of care and challenges with implementing new delivery-of-care models.
CONCLUSION
Although health care professionals and patients had some concerns about reduced visit schedules and use of televisits, several potential benefits were also noted. Our synthesis of qualitative evidence provides helpful insights into the perspectives, preferences, and experiences of important stakeholders with respect to implementing changes to prenatal care delivery that may complement findings of traditional quantitative evidence syntheses.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, CRD42021272287.
Topics: Pregnancy; Child; Female; Infant, Newborn; Humans; Prenatal Care; Health Personnel; Delivery of Health Care; Telemedicine; Perinatal Care
PubMed: 36649343
DOI: 10.1097/AOG.0000000000005046 -
Revista Brasileira de Ginecologia E... Aug 2018Evaluate the influence of prenatal care on the occurrence of gestational hypertension.
OBJECTIVE
Evaluate the influence of prenatal care on the occurrence of gestational hypertension.
METHODS
The Web of Science, Scopus, Pubmed, Cochrane and ClinicalTrials electronic databases were searched for articles published between January 1, 2012 and December 31, 2016. No language restrictions were imposed. The following keywords were used: prenatal care, medical assistance, prenatal education, pregnancy-induced hypertension. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist was employed. Two hundred and forty articles were identified during the initial search, but only seven met the inclusion criteria. This systematic review is registered with the international prospective register of systematic reviews (PROSPERO; #CRD42017064103).
RESULTS
The seven studies had a low risk of bias, with methodological quality scores ranging from six to eight points. Five studies found a positive relationship between prenatal care and pregnancy-induced hypertension, whereas two studies found no significant association between the two variables. The divergence among the studies may have been due to the type of healthcare service at which the study was conducted and the sample size.
CONCLUSION
Although the studies analyzed differed with regard to methodological aspects, the findings demonstrate the importance of prenatal care during the gestational period as a prevention and health promotion measure.
Topics: Case-Control Studies; Cohort Studies; Cross-Sectional Studies; Female; Humans; Hypertension, Pregnancy-Induced; Pregnancy; Prenatal Care; Syndrome
PubMed: 29925111
DOI: 10.1055/s-0038-1660526 -
International Journal of Gynaecology... Aug 2023Hormonal and behavioral changes during pregnancy may impact the oral health of women, which can influence the pregnancy course. Prenatal care practitioners (PCP) must be... (Review)
Review
BACKGROUND
Hormonal and behavioral changes during pregnancy may impact the oral health of women, which can influence the pregnancy course. Prenatal care practitioners (PCP) must be aware of this bidirectional relation in order to include an oral assessment in routine prenatal care.
OBJECTIVES
To characterize the knowledge and attitudes of PCP regarding oral health in pregnant women.
SEARCH STRATEGY
The search was carried out in PubMed, Web of Science, Lilacs, Scopus, and Embase on May 2022.
SELECTION CRITERIA
Peer-reviewed cross-sectional studies published in English within the last 5 years that assessed the knowledge, attitudes, and practices of PCP towards oral health in pregnancy were selected.
DATA COLLECTION AND ANALYSIS
Data were standardly extracted by the three reviewers from the selected articles and their bias was assessed.
MAIN RESULTS
From a total of 996 articles, 24 were selected. Overall, most PCP have an adequate level of knowledge regarding the importance of oral health during pregnancy. Although several professionals reported referring their patients to a dentist, the attitudes and practices of the majority of PCP were still inadequate.
CONCLUSIONS
PCP are aware of the importance of oral health during pregnancy but still lack translating this knowledge into clinical practice.
Topics: Pregnancy; Female; Humans; Prenatal Care; Oral Health; Health Knowledge, Attitudes, Practice; Cross-Sectional Studies; Pregnant Women
PubMed: 36710529
DOI: 10.1002/ijgo.14703 -
PLoS Medicine Dec 2019There is widespread, increasing use of magnesium sulphate in obstetric practice for pre-eclampsia, eclampsia, and preterm fetal neuroprotection; benefit for preventing... (Meta-Analysis)
Meta-Analysis
BACKGROUND
There is widespread, increasing use of magnesium sulphate in obstetric practice for pre-eclampsia, eclampsia, and preterm fetal neuroprotection; benefit for preventing preterm labour and birth (tocolysis) is unproven. We conducted a systematic review and meta-analysis to assess whether antenatal magnesium sulphate is associated with unintended adverse neonatal outcomes.
METHODS AND FINDINGS
CINAHL, Cochrane Library, LILACS, MEDLINE, Embase, TOXLINE, and Web of Science, were searched (inceptions to 3 September 2019). Randomised, quasi-randomised, and non-randomised trials, cohort and case-control studies, and case reports assessing antenatal magnesium sulphate for pre-eclampsia, eclampsia, fetal neuroprotection, or tocolysis, compared with placebo/no treatment or a different magnesium sulphate regimen, were included. The primary outcome was perinatal death. Secondary outcomes included pre-specified and non-pre-specified adverse neonatal outcomes. Two reviewers screened 5,890 articles, extracted data, and assessed risk of bias following Cochrane Handbook and RTI Item Bank guidance. For randomised trials, pooled risk ratios (RRs) or mean differences, with 95% confidence intervals (CIs), were calculated using fixed- or random-effects meta-analysis. Non-randomised data were tabulated and narratively summarised. We included 197 studies (40 randomised trials, 138 non-randomised studies, and 19 case reports), of mixed quality. The 40 trials (randomising 19,265 women and their babies) were conducted from 1987 to 2018 across high- (16 trials) and low/middle-income countries (23 trials) (1 mixed). Indications included pre-eclampsia/eclampsia (24 trials), fetal neuroprotection (7 trials), and tocolysis (9 trials); 18 trials compared magnesium sulphate with placebo/no treatment, and 22 compared different regimens. For perinatal death, no clear difference in randomised trials was observed between magnesium sulphate and placebo/no treatment (RR 1.01; 95% CI 0.92 to 1.10; 8 trials, 13,654 babies), nor between regimens. Eleven of 138 non-randomised studies reported on perinatal death. Only 1 cohort (127 babies; moderate to high risk of bias) observed an increased risk of perinatal death with >48 versus ≤48 grams magnesium sulphate exposure for tocolysis. No clear secondary adverse neonatal outcomes were observed in randomised trials, and a very limited number of possible adverse outcomes warranting further consideration were identified in non-randomised studies. Where non-randomised studies observed possible harms, often no or few confounders were controlled for (moderate to high risk of bias), samples were small (200 babies or fewer), and/or results were from subgroup analyses. Limitations include missing data for important outcomes across most studies, heterogeneity of included studies, and inclusion of published data only.
CONCLUSIONS
Our findings do not support clear associations between antenatal magnesium sulphate for beneficial indications and adverse neonatal outcomes. Further large, high-quality studies (prospective cohorts or individual participant data meta-analyses) assessing specific outcomes, or the impact of regimen, pregnancy, or birth characteristics on these outcomes, would further inform safety recommendations. PROSPERO: CRD42013004451.
Topics: Case-Control Studies; Eclampsia; Female; Humans; Magnesium Sulfate; Obstetric Labor, Premature; Parturition; Pre-Eclampsia; Pregnancy; Premature Birth; Prenatal Care; Prospective Studies
PubMed: 31809499
DOI: 10.1371/journal.pmed.1002988 -
American Journal of Obstetrics &... May 2021This study aimed to synthesize the qualitative literature on parental experiences of fetal care to reflect events that happened across the continuum of care and to... (Review)
Review
OBJECTIVE
This study aimed to synthesize the qualitative literature on parental experiences of fetal care to reflect events that happened across the continuum of care and to better understand parents' positive and negative experiences with care delivery.
DATA SOURCES
Eligible studies published until June 2020 were retrieved from MEDLINE, Embase, Cochrane Central Register of Controlled Trials, EBSCO CINAHL, Web of Science, and ProQuest.
STUDY ELIGIBILITY CRITERIA
Studies must have been: (1) published in English in a peer-reviewed journal or in ProQuest, (2) available in full text, (3) contained a qualitative component, and (4) focused on expectant parents' experiences of tertiary, coordinated, multidisciplinary prenatal diagnosis and care related to a fetal anomaly.
STUDY APPRAISAL AND SYNTHESIS METHODS
Researchers used the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. A metastudy and an interpretive description approach was taken to synthesize the events that happened across the continuum of care and the themes associated with a positive care experience.
RESULTS
The metasynthesis included 13 studies and 217 patients from 11 different multidisciplinary fetal diagnosis and intervention practices across North America and Europe. We identified key events that influenced parental experience of fetal care across the continuum. The themes associated with a positive care experience are parents (1) gaining understanding and feeling understood, (2) realizing agency and control, and (3) finding hope and meaning. We identified aspects of healthcare delivery that served as barriers or facilitators to these positive experiences.
CONCLUSION
Understanding the commonalities of the parental experience of fetal care across diverse settings creates a foundation for improving care and better meeting the needs of parents undergoing a painful and life-defining event. Although health outcomes are not always positive, a positive experience of care is possible and can assist parents to cope with their grief, manage their expectations, and engage in their care. The findings of this study illustrate the ways in which healthcare delivery can facilitate or obstruct a positive care experience.
Topics: Europe; Female; Humans; North America; Parents; Pregnancy; Prenatal Care; Qualitative Research
PubMed: 33493706
DOI: 10.1016/j.ajogmf.2021.100320