Gitsels - van der Wal, JT;
Gitsels, L;
Hooker, A;
van Weert, B;
Martin, L;
Feijen - de Jong, EI;
(2019)
Determinants and underlying causes of frequent attendance in midwife-led care: an exploratory cross-sectional study.
BMC Pregnancy and Childbirth
, 19
, Article 203. 10.1186/s12884-019-2316-5.
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Abstract
Background: An adequate number of prenatal consultations is beneficial to the health of the mother and fetus. Guidelines recommend an average of 5–14 consultations. Daily practice, however, shows that some women attend the midwifery practice more frequently. This study examined factors associated with frequent attendance in midwifery-led care. Methods: We conducted a cross-sectional study in a large midwifery practice in the Netherlands among low-risk women who started prenatal care in 2015 and 2016. Based on Andersen’s behavioral model, we collected data on potential determinants from the digital midwifery’s practice database. Prenatal healthcare utilization was measured by a revised version of the Kotelchuck Index, which measures a combination of care entry and numbers of visits. Logistic regression models were fitted to estimate the likelihood of frequent attendance compared to the recommended number of visits, adjusted for all relevant factors. Separate models were fitted on the non-referred and the referred group of obstetric-led care, as referral was found to be an effect modifier. Results: The prevalence of frequent attendance was 23% (243/1053), mainly caused by worries and/or vague complaints (44%; 106/243). Among non-referred women, 53% (560/1053), frequent attendance was associated with consultation with an obstetrician (OR = 3.99 (2.35–6.77)) and exposure to sexual violence (OR = 2.17 (1.11–4.24)). Among the referred participants, 47% (493/1053), frequent attendance was associated with a consultation with an obstetrician (OR = 2.75 (1.66–4.57)), psychosocial problems in the past or present (OR = 1.85 (1.02–3.35) or OR = 2.99 (1.43–6.25)), overweight (OR = 1.88 (1.09–3.24)), and deprived area (OR = 0.50 (0.27–0.92)). Conclusion: Our exploratory study indicates that the determinants of frequent attendance in midwifery-led care differs between non-referred and referred women. Underlying causes for frequent attendance was mainly because of non-medical reasons. Implication for practice: A trustful midwife-client relationship is known to be needed for clients such as frequent attenders to share more detailed, personal stories in case of vague complaints or worries, which is necessary to identify their implicit needs.
| Type: | Article |
|---|---|
| Title: | Determinants and underlying causes of frequent attendance in midwife-led care: an exploratory cross-sectional study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s12884-019-2316-5 |
| Publisher version: | https://doi.org/10.1186/s12884-019-2316-5 |
| Language: | English |
| Additional information: | This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
| Keywords: | Midwifery, Prenatal care, Patient acceptance of health care, Social determinants of health, Sexual violence, Psychosocial deprivation |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10076689 |
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