Women's maternity and birth experiences in the PREVENT-PE trial: A qualitative investigation.

BACKGROUND

Pre-eclampsia (PE) continues to be a major risk to maternal and fetal health, complicating up to 5% of all pregnancies, with no proven pharmacological intervention to reduce its incidence at term. Screening for pre-eclampsia risk at 35-36 weeks' gestation has been associated with a 30% reduction in the incidence of the primary outcome of PE, in The PREVENT-PE Trial.

METHODS

We aimed to understand women's maternity and birth experiences in The PREVENT-PE Trial. Semi-structured interviews were conducted with women (N = 80) from The PREVENT-PE Trial including those who were screened and had a timed birth (n = 37); those who were randomised to usual care (n = 31); and those who declined randomisation (n = 12). Data were subjected to a Template Analysis, based on findings from previous studies on maternity care experiences.

FINDINGS: We report on four key themes: Achieving Efficiencies with Research-embedded Clinical Care; Communicating Trial Information; Building Relationships with Care Providers; and Agency and Shared Decision-making. Maternity service delivery was deemed to be efficient as was the care they received during the trial. Volume of complex medical information caused concern; however, regular, consistent contact between women and their healthcare providers, helped women feel valued and understood; especially when they were provided with the opportunity to ask questions and have them answered.

CONCLUSION

Participation in an intervention trial within maternity care should embed principles of effective communication, relational care, shared decision-making, and efficient service delivery. Addressing these with not only enhance maternal experience but may also further promote greater participation in research.