Patient reported sources of support in the prenatal care of pregnancies complicated by surgical fetal anomalies: a qualitative study.

INTRODUCTION Pregnancy complications and social risk factors increase "pregnancy anxiety" and adversely affect maternal and neonatal outcomes. Social support is recognized as key to mitigating antenatal stress and improving birth outcomes. Our aim is to explore patient-reported support systems that can be bolstered to provide holistic, patient-centered care to expectant mothers with a fetal diagnosis.

Methods

We conducted this qualitative study through semi-structured interviews of patients recently diagnosed with surgical fetal anomalies from 8/2021-12/2021 at a large tertiary fetal center. Line-by-line coding and thematic analysis were performed to identify emerging themes.

Results

Eighteen interviews were conducted. Participants had a mean age of 30 years (range 18-36), were predominantly married (n=16, 89%), and self-identified as Caucasian (n=16, 89%). While half were Hispanic (n=9, 50%), most spoke English as their primary language (n=13, 72%). The mean gestational age at the time of interview was 27 weeks (range 20-37). Expectant mothers described various support systems that helped them cope with their psychological stress related to the diagnosis, including their healthcare providers, family and friends, religion, and mothers with similar diagnoses.

Conclusion

Expectant mothers with prenatally diagnosed surgical fetal anomalies draw support beyond traditional social support. Unlike general antenatal populations, support of these families must address the dual role of mother as both patient and pediatric caregiver. Bolstering these support sources to provide specialized peer and informational networks that address this unique unmet need can improve the maternal prenatal experience through designing targeted interventions to link at-risk patients with appropriate resources.