Exploring Patients’ Needs & Desires for Quality Prenatal Care in Florida

Introduction Early and adequate prenatal care is important for patients to obtain health education, risk reduction, psychosocial support, and necessary medical interventions during the prenatal period. High-quality prenatal care encourages adequate care throughout pregnancy by increasing patients’ desires to return for subsequent visits. This study aims to investigate the prenatal care experiences, desires, and needs of women in Florida. Methods A mixed-methods study was conducted from April to December 2019 with postpartum women (n=55) who received no or late prenatal care and delivered in [City], Florida. Eligible women completed a survey and a semi-structured interview. The interview contextualized conditions shaping perceptions of the quality of prenatal care. Univariate analysis was conducted on the demographic characteristics and prenatal care locations. Qualitative analysis was performed using MAXQDA software and modified grounded theory. The analysis was based on Donabedian’s quality of care model. Results The participants self-identified as Hispanic (52%), White (48%), and Black (21%). Sixty-nine percent had Medicaid while 22% were self-pay. In the qualitative analysis, three core themes emerged. Clinical care processes included provision of health education and medical assessments. Structural conditions included language barriers, clinic availability, and ancillary staff presence. Lastly, interpersonal communication included impersonal care and multiple providers. The overarching conclusion from this analysis was the desire for patient-centered care. Participants wanted the care they received to be informative, tailored to their needs, and to work within the realities of their everyday lives. Discussion Investigating women’s experiences with seeking and receiving prenatal care are necessary to inform future interventions. Fostering a positive and patient-centered healthcare environment is necessary to improve the quality of care. Quick points What is already known on this subject? Racial and ethnic disparities exist in prenatal care access, utilization and both maternal and infant mortality and morbidity. Timely and adequate prenatal care is an important determinant for maternal and infant birth outcomes. What this study adds This study identified process, structure, and interpersonal factors associated with prenatal care access and utilization from the perspectives of a diverse group of postpartum women. Specific recommendations for patient-centered prenatal care for diverse women in the context of patient expectations and perceptions of quality are provided.