Downe S, Finlayson K, Tunçalp Ӧ, Metin Gülmezoglu A
Research in Childbirth and Health (ReaCH) group, University of Central Lancashire, Preston, UK.
Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
BJOG. 2016 Mar;123(4):529-39. doi: 10.1111/1471-0528.13819. Epub 2015 Dec 24.
Global uptake of antenatal care (ANC) varies widely and is influenced by the value women place on the service they receive. Identifying outcomes that matter to pregnant women could inform service design and improve uptake and effectiveness.
To undertake a systematic scoping review of what women want, need and value in pregnancy.
Eight databases were searched (1994-2015) with no language restriction. Relevant journal contents were tracked via Zetoc.
An initial analytic framework was constructed with findings from 21 papers, using data-mining techniques, and then developed using meta-ethnographic approaches. The final framework was tested with 17 more papers.
All continents except Australia were represented. A total of 1264 women were included. The final meta-theme was: Women want and need a positive pregnancy experience, including four subthemes: maintaining physical and sociocultural normality; maintaining a healthy pregnancy for mother and baby (including preventing and treating risks, illness and death); effective transition to positive labour and birth; and achieving positive motherhood (including maternal self-esteem, competence, autonomy). Findings informed a framework for future ANC provision, comprising three equally important domains: clinical practices (interventions and tests); relevant and timely information; and pyschosocial and emotional support; each provided by practitioners with good clinical and interpersonal skills within a high quality health system.
A positive pregnancy experience matters across all cultural and sociodemographic contexts. ANC guidelines and services should be designed to deliver it, and those providing ANC services should be aware of it at each encounter with pregnant women.
Women around the world want ANC staff and services to help them achieve a positive pregnancy experience.
全球产前护理（ANC）的接受情况差异很大，并且受到女性对其所接受服务重视程度的影响。确定对孕妇重要的结果可为服务设计提供参考，并提高接受率和有效性。
对女性在孕期想要、需要和重视的内容进行系统的范围综述。
检索了八个数据库（1994 - 2015年），无语言限制。通过Zetoc跟踪相关期刊内容。
利用数据挖掘技术，根据21篇论文的研究结果构建了一个初始分析框架，然后采用元民族志方法进行完善。最终框架又用另外17篇论文进行了检验。
除澳大利亚外，各大洲均有代表。共纳入1264名女性。最终的元主题是：女性希望并需要有积极的孕期体验，包括四个子主题：保持身体和社会文化正常状态；为母婴维持健康的孕期（包括预防和治疗风险、疾病及死亡）；顺利过渡到积极的分娩过程；以及实现积极的母亲角色（包括母亲的自尊、能力和自主性）。研究结果为未来的产前护理提供了一个框架，包括三个同等重要的领域：临床实践（干预措施和检查）；相关且及时的信息；以及心理社会和情感支持；每个领域都由具备良好临床和人际沟通技能的从业者在高质量的卫生系统中提供。
积极的孕期体验在所有文化和社会人口背景下都很重要。产前护理指南和服务应旨在提供这种体验，提供产前护理服务的人员在每次与孕妇接触时都应意识到这一点。
世界各地的女性希望产前护理人员和服务能帮助她们获得积极的孕期体验。
