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Seizing the 9-month moment: addressing behavioral risks in prenatal patients
Karen Herzig1, Dale Danley, Rebecca Jackson
1Division of Behavioral Sciences, University of California San Francisco, 350 Parnassus Avenue, Suite 905, San Francisco, CA 94117, USA.
Patient Education and Counseling
|November 1, 2005
Summary
Prenatal care providers use patient-centered strategies to address behavioral risks like substance use and domestic violence during pregnancy. Brief, routine counseling can significantly impact patient behavior change.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Behavioral Health
Background:
- Identifying and addressing behavioral risks in pregnant women is crucial for maternal and fetal well-being.
- Prenatal care providers face challenges in counseling patients on sensitive issues such as smoking, alcohol, drug use, and domestic violence.
Purpose of the Study:
- To explore how prenatal care providers identify and counsel pregnant women regarding smoking, alcohol use, illicit drug use, and domestic violence.
- To understand the strategies and challenges associated with risk-prevention counseling in prenatal care.
Main Methods:
- A qualitative study involving six focus groups with 49 OB/Gyn physicians, nurse practitioners, and certified nurse midwives.
- Open-ended questions were used, and transcripts were analyzed to identify emergent themes.
Main Results:
- Three major themes emerged: existence of effective risk-prevention tactics, addressing patient isolation/depression, and adopting a "chipping away" approach to risks.
- Specific tactics included normalizing risk prevention, targeted assessment and counseling, patient-centered smoking reduction, and family involvement.
Conclusions:
- Addressing behavioral risks during pregnancy is challenging but achievable with patient-centered techniques and understanding social contexts.
- Brief, routine assessments and risk reduction messages are effective and can lead to significant patient changes over time.