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Exploring prenatal care experiences in Ontario, Canada: An equity-oriented qualitative study.

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Equity-oriented prenatal care significantly impacts patient satisfaction and health outcomes. This study highlights how social determinants of health create inequities, affecting marginalized populations

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Area of Science:

  • Health Services Research
  • Sociology of Health
  • Maternal Health

Background:

  • Equity-oriented prenatal care is crucial for patient satisfaction, care-seeking, and health outcomes.
  • Social determinants of health disproportionately impact marginalized populations' care experiences.
  • This study investigates prenatal patients' experiences and the influence of health inequities.

Purpose of the Study:

  • To explore prenatal patients' care experiences.
  • To examine the impact of health inequities on these experiences.
  • To identify factors influencing patient satisfaction and health outcomes in prenatal care.

Main Methods:

  • Qualitative, patient-partner-oriented, cross-sectional study using Cochrane's PROGRESS-Plus equity framework.
  • Purposeful, maximum variation sampling of 18 participants in Ontario, Canada (pregnant or experienced pregnancy loss within 12 months).
  • Semi-structured interviews and sociodemographic survey, analyzed using descriptive and content analysis.

Main Results:

  • Participants reported experiences ranging from powerlessness to continuity challenges, influenced by geographical and financial barriers.
  • Patient-centered care experiences included empathetic practitioners and validation, but were affected by discrimination and power dynamics.
  • Half of participants identified as racial minorities, with diverse healthcare professional interactions (physicians, nurses, midwives).

Conclusions:

  • Findings can improve pregnancy care through targeted access, reduced patient-provider hierarchies, and culturally sensitive approaches.
  • Enhancing trust through culturally sensitive care and community engagement is vital.
  • Healthcare professionals and policymakers can use findings to meet patient expectations for equity-oriented prenatal care.