Meeting the needs of pregnant women in socially vulnerable situations: A phenomenological qualitative study
Béatrice Lognos,
Agnès Oude Engberink,
Lorène Gonzalez,
Julia Leandri,
Carla Charlot Pisoni,
Nadia Rachedi,
Bernard Clary,
Gérard Bourrel,
Sabine Bayen,
Elodie Million
Affiliations
Béatrice Lognos
University of Montpellier, UMR UA11 INSERM – UM IDESP Institut Desbrest d’Épidémiologie et de Santé Publique Campus Santé, IURC, 641 avenue du doyen Gaston Giraud, 34 093, France; Department of General Practice, Montpellier University of Montpellier, 34000 Montpellier, France; Maison de santé pluriprofessionnelle universitaire Pauline Lautaud (ST Georges d’Orques, Castries, Prades le Lez, Vendargues), France; Corresponding author. Maison de Santé Pluri professionnelle Universitaire Pauline Lautaud, 4 avenue d’Occitanie, 34680 ST Georges d’Orques, France.
Agnès Oude Engberink
University of Montpellier, UMR UA11 INSERM – UM IDESP Institut Desbrest d’Épidémiologie et de Santé Publique Campus Santé, IURC, 641 avenue du doyen Gaston Giraud, 34 093, France; Department of General Practice, Montpellier University of Montpellier, 34000 Montpellier, France; Maison de santé pluri professionnelle universitaire Avicenne, 2 rue IBN Sinaï dit Avicenne 66 330 Cabestany, France
Lorène Gonzalez
University of Montpellier, UMR UA11 INSERM – UM IDESP Institut Desbrest d’Épidémiologie et de Santé Publique Campus Santé, IURC, 641 avenue du doyen Gaston Giraud, 34 093, France; Department of General Practice, Montpellier University of Montpellier, 34000 Montpellier, France; Maison de santé pluriprofessionnelle universitaire Pauline Lautaud (ST Georges d’Orques, Castries, Prades le Lez, Vendargues), France; Maison de santé pluri professionnelle universitaire Avicenne, 2 rue IBN Sinaï dit Avicenne 66 330 Cabestany, France; Département de L’Hérault, Hôtel du Département mas d’Alco, 1977 avenue du mas de Moulin 34087 Montpellier, France; Maison de Santé Professionnelle 20 route Minervois, 11800 Trèbes, France; Department of General Practice, Pôle formation Faculté médecine H. Warembourg 59045 Lille CEDEX 1, University of Lille, 1, place de Verdun, 59045, France; Centre médical, Rue de la Brèche, 34630 Saint-Thibéry, France
Julia Leandri
Maison de santé pluriprofessionnelle universitaire Pauline Lautaud (ST Georges d’Orques, Castries, Prades le Lez, Vendargues), France
Carla Charlot Pisoni
Maison de santé pluriprofessionnelle universitaire Pauline Lautaud (ST Georges d’Orques, Castries, Prades le Lez, Vendargues), France
Nadia Rachedi
Département de L’Hérault, Hôtel du Département mas d’Alco, 1977 avenue du mas de Moulin 34087 Montpellier, France
Bernard Clary
University of Montpellier, UMR UA11 INSERM – UM IDESP Institut Desbrest d’Épidémiologie et de Santé Publique Campus Santé, IURC, 641 avenue du doyen Gaston Giraud, 34 093, France; Department of General Practice, Montpellier University of Montpellier, 34000 Montpellier, France; Maison de Santé Professionnelle 20 route Minervois, 11800 Trèbes, France
Gérard Bourrel
University of Montpellier, UMR UA11 INSERM – UM IDESP Institut Desbrest d’Épidémiologie et de Santé Publique Campus Santé, IURC, 641 avenue du doyen Gaston Giraud, 34 093, France; Department of General Practice, Montpellier University of Montpellier, 34000 Montpellier, France
Sabine Bayen
Department of General Practice, Pôle formation Faculté médecine H. Warembourg 59045 Lille CEDEX 1, University of Lille, 1, place de Verdun, 59045, France
Elodie Million
University of Montpellier, UMR UA11 INSERM – UM IDESP Institut Desbrest d’Épidémiologie et de Santé Publique Campus Santé, IURC, 641 avenue du doyen Gaston Giraud, 34 093, France; Department of General Practice, Montpellier University of Montpellier, 34000 Montpellier, France; Maison de santé pluriprofessionnelle universitaire Pauline Lautaud (ST Georges d’Orques, Castries, Prades le Lez, Vendargues), France
Objective: Vulnerability relates to fragile physical, psychological, and socio-environmental circumstances. Pregnant women's social vulnerability can lead to disruptions in their medical follow-ups, prematurity, and increased infant mortality rates, such that their special needs must be considered. Yet, despite different governments' ‘perinatality’ plans, international literature suggests their care can be improved. Although quantitative studies regularly evaluate these plans, few studies have assessed vulnerable pregnant women's views. This study explores the needs and expectations of vulnerable women regarding their follow-ups during pregnancy and identified strategies to improve their circumstances. Methods: The study was a phenomenological qualitative study involving semi-structured interviews with women who gave birth in the past six months (December 2017 to June 2018) and who fulfilled at least one vulnerability criterion. The women were recruited by French midwives and general practitioners (GPs). Findings: Concerning these vulnerable pregnant women, three phenomenological categories emerged: 1) they need to be monitored by a single trusted contact; 2) they seek medical and social support adapted to their situations that addresses their needs; and 3) they expect kind and person-centred communication skills from professionals who provide them appropriate information. Conclusion: We identified various international recommendations to screen and care for vulnerable pregnant women, but still these women often experience numerous challenges. Finally, the implementation of recommendations for healthcare professionals based on women's real-life experiences could help optimise the identification of vulnerable pregnant women as well as their follow-up care.
