Autonomy support in prenatal consultation: A quantitative observation study in maternity care

Area of Science:

• Maternal Health
• Healthcare Communication
• Psychology

Background:

• Pregnancy involves complex decisions requiring professional guidance.
• Current practices often prioritize information over decision support.
• Self-determination theory (SDT) suggests fulfilling autonomy, competence, and relatedness needs enhances patient choice.

Purpose of the Study:

• To quantify autonomy-supportive and autonomy-thwarting interactions in prenatal consultations.
• To assess the association between these interactions and women's perceived healthcare climate.

Main Methods:

• Quantitative observational study with a cross-sectional design (March-October 2020).
• 23 maternity care professionals across 2 hospitals and 16 midwifery practices.
• 104 audiotaped prenatal consultations coded using a specialized tool; perceived healthcare climate assessed via Healthcare Climate Questionnaire.

Main Results:

• Professionals utilized a limited range of autonomy-supportive interactions.
• More interactions provided autonomy (giving room) than stimulated active engagement.
• Structuring interactions were more informative than supportive.
• Women generally perceived the healthcare climate positively.

Conclusions:

• Women were infrequently encouraged towards active engagement, crucial for woman-centered decision-making.
• Professionals can improve autonomy-supportive climates by emphasizing interactions with women and providing structure.