The psychological impact of providing women with risk information for pre-eclampsia: a qualitative study.

OBJECTIVE

a new first-trimester universal antenatal screening test for pre-eclampsia was introduced into two UK hospitals. The aim of this study was to investigate the potential psychological benefits, harms and acceptability of providing pregnant women with formal risk information for pre-eclampsia.

DESIGN

cross-sectional interview study. Women were interviewed using a theoretically informed semi-structured schedule and transcripts were analysed thematically using Framework Analysis.

SETTING AND PARTICIPANTS

primigravid women receiving antenatal care at a central London National Health Service Foundation Trust found either high-risk or low-risk for pre-eclampsia.

FINDINGS

15 primigravid women who received high risk (n=10) or low risk (n=5) results of a 12-week pre-eclampsia screening test were interviewed. Two types of coping typologies were evident from the data. The first were 'danger managers' who had an internal sense of control, were focused on the risk that pre-eclampsia presented to them and exhibited information seeking, positive behaviour changes, and cognitive reappraisal coping mechanisms. The second were 'fear managers' who had an external sense of control, were focused on the risk that pre-eclampsia presented to the fetus, and exhibited avoidance coping mechanisms. In addition to these typologies, three universal themes of 'medicalising the pregnancy', 'embracing technology' and 'acceptability' emerged from the data.

KEY CONCLUSIONS

there are potential positive and negative unintended consequences following a first-trimester screening test for pre-eclampsia. A positive consequence could be self-instigated behaviour change, whereas a negative consequence could be reduced self-monitoring of fetal movements as the pregnancy develops.

IMPLICATIONS FOR PRACTICE

this study indicates that women with an increased risk of pre-eclampsia would be willing to engage in efforts to reduce their risk of pre-eclampsia, and there is a potential to use this screening test as a basis for improving health more broadly.