Skip to main content

Advertisement

SpringerLink
Log in

A Qualitative Study of Women’s Experiences of Communication in Antenatal Care: Identifying Areas for Action

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

To identify key features of communication across antenatal (prenatal) care that are evaluated positively or negatively by service users. Focus groups and semi-structured interviews were used to explore communication experiences of thirty pregnant women from diverse social and ethnic backgrounds affiliated to a large London hospital. Data were analysed using thematic analysis. Women reported a wide diversity of experiences. From the users’ perspective, constructive communication on the part of health care providers was characterised by an empathic conversational style, openness to questions, allowing sufficient time to talk through any concerns, and pro-active contact by providers (e.g. text message appointment reminders). These features created reassurance, facilitated information exchange, improved appointment attendance and fostered tolerance in stressful situations. Salient features of poor communication were a lack of information provision, especially about the overall arrangement and the purpose of antenatal care, insufficient discussion about possible problems with the pregnancy and discourteous styles of interaction. Poor communication led some women to become assertive to address their needs; others became reluctant to actively engage with providers. General Practitioners need to be better integrated into antenatal care, more information should be provided about the pattern and purpose of the care women receive during pregnancy, and new technologies should be used to facilitate interactions between women and their healthcare providers. Providers require communications training to encourage empathic interactions that promote constructive provider–user relationships and encourage women to engage effectively and access the care they need.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Joosten, E. A. G., Fuentes-Merillas, L., de Weert, G. H., Sensky, T., van der Staak, C. P. F., & de Jong, C. A. J. (2008). Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status. Psychotherapy and Psychosomatics, 77(4), 219–226.

    Article  CAS  PubMed  Google Scholar 

  2. Ong, L. M., de Haes, J. C., Hoos, A. M., & Lammes, F. B. (1995). Doctor–patient communication: A review of the literature. Social Science and Medicine, 40(7), 903–918.

    Article  CAS  PubMed  Google Scholar 

  3. Rowe, R. E., Garcia, J., Macfarlane, A. J., & Davidson, L. L. (2002). Improving communication between health professionals and women in maternity care: A structured review. Health Expectations, 5(1), 63–83.

    Article  PubMed  Google Scholar 

  4. Stewart, M. A. (1995). Effective physician–patient communication and health outcomes: A review. Canadian Medical Association Journal, 152(9), 1423–1433.

    CAS  PubMed  Google Scholar 

  5. Conti, A. A., & Gensini, G. F. (2008). Doctor–patient communication: A historical overview. Minerva Medica, 99(4), 411–415.

    CAS  PubMed  Google Scholar 

  6. DH. (2007). Maternity matters: Choice, access and continuity of care in a safe service. London: Department of Health.

    Google Scholar 

  7. Garcia, J., Redshaw, M., Fitzsimons, B., & Keene, J. (1998). First class delivery: A national survey of women’s views of maternity care. London: Audit Commission.

    Google Scholar 

  8. General Medical Council. (2003). Tomorrow’s doctors: Regulating doctors. Ensuring good medical practice. London: General Medical Council.

    Google Scholar 

  9. DH. (1993). Changing childbirth. Report of the expert Maternity Group, part 1. The Cumberlege report. London: HMSO.

    Google Scholar 

  10. DH. (2004). National Service Framework for children, young people and maternity services: Maternity service. London: DH.

    Google Scholar 

  11. Royal College of Obstetricians and Gynaecologists, Royal College of Midwives, Royal College of Anaesthetists, Royal College of Paediatrics and Child Health. (2008). Standards for maternity care: Report of a working party. London: RCOG Press.

    Google Scholar 

  12. Teutsch, C. (2003). Patient–doctor communication. Medical Clinics of North America, 87(5), 1115–1145.

    Article  PubMed  Google Scholar 

  13. Healthcare Commission. (2008). Towards better births: A review of maternity services in England. Commission for Healthcare Audit and Inspection.

  14. Fraser, D. M. (1999). Women’s perceptions of midwifery care: A longitudinal study to shape curriculum development. Birth, 26(2), 99–107.

    Article  CAS  PubMed  Google Scholar 

  15. Khan, S., & Jones, A. (2002). Somalis in Camden: Challenges faced by an emerging community. London: Camden Council.

    Google Scholar 

  16. Morgan, D. L. (1998). Focus group kit. Thousand Oaks, CA: Sage.

    Google Scholar 

  17. Office for National Statistics. (2008). Census 2001—Ethnicity and religion in England and Wales. Retrieved December 17, 2009, from http://www.statistics.gov.uk/census2001/profiles/commentaries/ethnicity.asp

  18. Krueger, R. A., & Casey, M. A. (2000). Focus groups: A practical guide for applied research (3rd ed.). Thousand Oaks, CA: Sage.

    Google Scholar 

  19. Allen, P., Black, N., Clarke, A., Fulop, N., & Anderson, S. (2001). Studying the organization and the delivery of the health services: Research methods. London: Routledge.

    Google Scholar 

  20. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.

    Article  Google Scholar 

  21. Fulop, N., Allen, P., Clarke, A., & Black, N. (2001). Studying the organisation and delivery of health services: Research methods. London: Routledge.

    Google Scholar 

  22. Raine, R., Carter, S., Sensky, T., & Black, N. (2005). Referral into a void: Opinions of general practitioners and others on single point of access to mental health care. Journal of the Royal Society of Medicine, 98(4), 153–157.

    Article  PubMed  Google Scholar 

  23. Sword, W. (2003). Prenatal care use among women of low income: A matter of “taking care of self”. Qualitative Health Research, 13(3), 319–332.

    Article  PubMed  Google Scholar 

  24. Liddell, A., Adshead, S., & Burgess, E. (2008). Technology in the NHS: Transforming the patient’s experience of care. London: King’s Fund.

    Google Scholar 

  25. O’Cathain, A., Coleman, P., & Nicholl, J. (2008). Characteristics of the emergency and urgent care system important to patients: A qualitative study. Journal of Health Services Research & Policy, 13(Suppl 2), 19–25.

    Article  Google Scholar 

  26. Redshaw, M., Rowe, R. E., Hockley, C., & Brocklehurst, P. (2007). Recorded delivery: A national survey of women’s experiences of maternity care 2006. Oxford: National Perinatal Epidemiology Unit, University of Oxford.

    Google Scholar 

  27. Harper Bulmam, K., & McCourt, C. (2002). Somali refugee women’s experiences of maternity care in west London: A case study. Critical Public Health, 12(4), 365–380.

    Article  Google Scholar 

  28. Leithner, K., ssem-Hilger, E., Fischer-Kern, M., Loffler-Stastka, H., Thien, R., & Ponocny-Seliger, E. (2006). Prenatal care: The patient’s perspective. A qualitative study. Prenatal Diagnosis, 26(10), 931–937.

    Article  PubMed  Google Scholar 

  29. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.

    Google Scholar 

  30. Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267–283.

    Article  CAS  PubMed  Google Scholar 

  31. Katz, J. N. (2001). Patient preferences and health disparities. Journal of the American Medical Association, 286(12), 1506–1509.

    Article  CAS  PubMed  Google Scholar 

  32. Schouten, B. C., & Meeuwesen, L. (2006). Cultural differences in medical communication: A review of the literature. Patient Education and Counseling, 64(1–3), 21–34.

    Article  PubMed  Google Scholar 

  33. Willems, S., De Maesschalck, S., Deveugele, M., Derese, A., & De Maeseneer, J. (2005). Socio-economic status of the patient and doctor–patient communication: Does it make a difference? Patient Education and Counseling, 56(2), 139–146.

    Article  CAS  PubMed  Google Scholar 

  34. Pilnick, A. (2008). ‘It’s something for you both to think about’: Choice and decision making in nuchal translucency screening for Down’s syndrome. Sociology of Health & Illness, 30(4), 511–530.

    Google Scholar 

  35. Fassaert, T., van, D. S., Schellevis, F., & Bensing, J. (2007). Active listening in medical consultations: Development of the Active Listening Observation Scale (ALOS-global). Patient Education and Counseling, 68(3), 258–264.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank all of the women that took part in this study, the midwives who allowed us to recruit participants and Donald Peebles for his clinical advice. We also thank Tasneen Khan for helping with recruitment and acting as an interpreter for the Bengali speaking focus group, Edna Farah Dahir, Shamsun Choudhury and Abul Hussain Khondoker for their translation of Bengali, Sylheti and Somali language interviews into English, Mahbuba Begum for acting as an interpreter for Bengali language interviews and Danielle Maher for transcribing some of the English language interviews. The study was approved by the Joint University College London/University College London Hospitals NHS Foundation Trust Committee on the Ethics of Human Research (Committee Alpha). Study number: 08/H0715/16. The study was funded by the Clinical Research and Development Committee (UCLH Charities). Reference: GCT/2007/MC. RR is partly funded by a NIHR Public Health Career Scientist Award and by the NIHR UCLH/UCL Comprehensive Biomedical Research Centre.

Author information

Authors and Affiliations

  1. Health Care Evaluation Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK

    Rosalind Raine & Martin Cartwright

  2. University College London Hospitals NHS Foundation Trust, 2nd Floor North, 250 Euston Road, London, NW1 2PG, UK

    Yana Richens

  3. Camden Council, Crowndale Centre, 218 Eversholt Street, London, NW1 1BD, UK

    Zuhura Mahamed

  4. Sub-Department of Clinical Health Psychology, Centre for Outcomes Research and Effectiveness (CORE), University College London, 1-19 Torrington Place, London, WC1E 7HB, UK

    Debbie Smith

Authors
  1. Rosalind Raine
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin Cartwright
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yana Richens
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zuhura Mahamed
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Debbie Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rosalind Raine.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Raine, R., Cartwright, M., Richens, Y. et al. A Qualitative Study of Women’s Experiences of Communication in Antenatal Care: Identifying Areas for Action. Matern Child Health J 14, 590–599 (2010). https://doi.org/10.1007/s10995-009-0489-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-009-0489-7

Keywords

Search

Navigation