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The reasons why Flemish low-risk nulliparous pregnant women choose a specific antenatal care provider: A descriptive
Annelore Cloostermans1, Ayse Akalin2,3,4, Joeri Vermeulen2,5,6
1Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
Introduction:
In Belgium, low-risk pregnant women have the option of consulting an obstetrician, midwife, or general practitioner for antenatal care. Although consultations with midwives have increased over the years, obstetricians remain the most frequently consulted providers, even for low-risk pregnancies. However, the reasons behind provider choice remain unclear. The aim of this study was to ascertain the reasons why Flemish low-risk nulliparous pregnant women choose a specific antenatal care provider.
Methods:
A descriptive qualitative study was carried out in Flanders, Belgium, between March and May 2024, with Flemish low-risk nulliparous pregnant women. Semi-structured individual interviews were conducted by a female midwife experienced in qualitative research. An open-ended interview guide was used to explore participants' decision-making processes, experiences with antenatal care providers, expectations of care, and perceived roles of antenatal care providers. Braun and Clarke's six-step thematic analysis was applied to analyze the data in NVivo®.
Results:
Thirteen women were interviewed. Their choice of antenatal care provider was shaped by perceptions of medical expertise, accessibility, social influences, and structural constraints. Obstetricians were commonly preferred for their specialization and access to technology, whereas midwives were valued for relational and emotional support once women became aware of their role. Five overarching themes were identified: trust in professional expertise, practical accessibility of care, influence of social environment and informational gaps, need for relational continuity and emotional support, and structural and organizational constraints.
Conclusions:
The decision-making process for choosing an antenatal care provider is multidimensional and varies among Flemish low-risk nulliparous women. Further research is needed to explore healthcare professionals' perspectives on low-risk antenatal care pathways and to examine how different models of antenatal care shape women's decision-making processes and care experiences.