Redding, Noura (2015). Understanding women’s preferences, choices and expectations of group versus individual prenatal care. McGill Family Medicine Studies Online, 10: e02.7

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Context: The intent of group prenatal care is to enable better preparation for pregnancy and birth. It is essential to understand the factors that influence women to choose group versus individual prenatal care. This sub-study of a larger implementation project aims to explore women’s preconceptions, choices and expectations of care among both Canadian-born and immigrant women choosing between group and individual prenatal care.

Objective: The objectives of this study were: (1) To understand the preconceptions women have of group prenatal care; (2) To explore the factors that influence women to choose group versus individual prenatal care; and (2) To describe the differences in expectations and choices of prenatal care between Canadian-born and immigrant women.

Methods and Participants: This study adopted a qualitative descriptive approach. Participants of the study consisted of Canadian-born and immigrant pregnant women receiving individual (n = 6) and group (n = 6) prenatal care at an academic primary care clinic serving a multicultural population. Inclusion criteria included: age 18 or older, low-risk, singleton pregnancies, followed by a staff family physician, and fluency in French or English. Purposeful sampling was used to attain variation based on age, parity and elapsed time in Canada. Individual semi-structured, in-depth interviews were conducted either at clinic, home, or preferred location; interviews were audio-recorded and transcribed verbatim. A hybrid deductive-inductive approach was used to thematically analyze the data.

Results: Nine main themes emerged from the interview data and presented as per the three study objectives. 1) Three main themes were identified for women’s preconceptions of group prenatal: a lack of understanding and unfamiliarity with group prenatal care; perceived benefits that attract women to group prenatal care; and concerns with a group format of care that may deter women from choosing this model. 2) Four themes emerged related to factors influencing women’s choices of prenatal care: feelings about pregnancy; prenatal care preferences; perceived need for and access to social support; and past experiences with healthcare providers. 3) Two themes emerged that illustrated two key differences in expectations of prenatal care between Canadian-born and immigrant women’s choices: overall expectations of prenatal care and cultural preferences in regards to type of healthcare provider and individual versus group care.

Conclusions: Findings through this study indicate that a group prenatal care model is attractive to women seeking holistic care typical of midwifery. It appears that a group format of care may offer additional social support for some women seeking additional help, if their friends and family are less available in their social networks. In order to promote the model, providers of maternity care services should enhance efforts to inform women of the option to receive this type of care and address the concerns some women may have with privacy and adequate one-on-one time with the physician.