Adequate Prenatal Care: An Integrative Review

Area of Science:

• Public Health
• Maternal and Child Health
• Healthcare Quality

Background:

• Prenatal care (PNC) is crucial for maternal and fetal health, yet national and international guidelines for adequate care vary.
• Current indices often focus solely on visit frequency, neglecting patient access and care quality factors.
• Stakeholder perceptions of adequate and quality PNC are essential for improving care standards.

Purpose of the Study:

• To explore diverse stakeholder perceptions of adequate and quality prenatal care (PNC).
• To identify gaps in the literature regarding the definition and measurement of PNC adequacy and quality.
• To inform future research for establishing consensus definitions of PNC quality.

Main Methods:

• An integrative review of original research articles published between 2012 and April 2022.
• Searched CINAHL, PubMed, and Web of Science databases for studies focused on adequate or quality PNC in the US.
• Assessed the quality of included studies using the Quality Assessment Tool for Studies with Diverse Designs.

Main Results:

• Thirteen articles met the inclusion criteria, revealing that 'adequate' and 'quality' PNC are not well-defined in existing literature.
• Studies showed varied approaches to assessing PNC components, with conflicting results on what constitutes adequate or quality care.
• Stakeholder viewpoints (researchers, public health officials, insurers, providers, patients) were limited by individual interpretations.

Conclusions:

• A significant gap exists in defining and measuring the concepts of adequate and quality prenatal care.
• Redesigning PNC is influenced by study setting, stakeholders, and the integration of telehealth.
• Future research must identify key PNC components to establish consensus definitions for adequacy and quality.