General Practitioners’ Perceived Indicators of Vulnerability in Pregnancy- A Qualitative Study

Abstract Objective To explore general practitioners’ (GPs’) perceived indicators of vulnerability among pregnant women in primary care. Design A qualitative study with semi-structured in-depth focus group interviews. Setting General practices located in a mixture of urban, semi-urban and rural practices throughout the Region of Southern Denmark Subjects Twenty GPs between 32 and 56 years of age. Main outcome measures Through qualitative analysis and systematic text condensation of the interview data, the following themes emerged: (1) obvious indicators of vulnerability - i.e. somatic or psychological illnesses, or complex social problems and 2) intangible indicators of vulnerability – i.e. identification depended on the GPs’ gut-feeling. From the GPs’ perspective, the concept of vulnerability in pregnancy were perceived as the net result of risk factors and available individual and social resources, with a psychosocial etiology was the dominant framework. Conclusions The GPs demonstrated a broad variety of perceived indicators of vulnerability in pregnancy; most importantly, the GPs were aware of a group of pregnant women with intangible vulnerability. Despite not fitting into the GPs perceived concept of vulnerability, the GPs had a gut feeling that these women might be vulnerable. Misjudging the resources of pregnant women due to their physical appearance could delay the GPs’ identification of vulnerability. Future studies should explore the challenges GPs experiences when assessing vulnerability among pregnant women.