Assessing vulnerable pregnant women in General Practice

Background
Vulnerability with low mental health and complex social problems is increasing among non-pregnant women. Unacknowledged vulnerability in pregnancy has high risk of negative impact on the health of the mother, the birth, and the childhood. The GPs’ often have a longstanding familiarity about their patients and are the first health professionals the women meet before and during the early pregnancy. GPs’ have an important task to evaluate the pregnant women’s health risk and resources to decide the right levels of antenatal care. However, reports point a gap in the antenatal care for vulnerable pregnant women, as less than 25% of the pregnant women with severe vulnerability are identified in Danish general practice, and that barriers for the GPs’ identification and management of vulnerable pregnant women are inconsistent teamwork between GPs and cross-sectoral partners in antenatal care.

Aim
The aim is to analyze the GPs’ attitudes and perceived barriers and facilitators for proper assessment of vulnerability among pregnant women. Specific focus is applied on challenges in the cross-sectoral collaboration in antenatal care and in the decision of reporting vulnerable pregnant women to social authorities.

Method
In qualitative focus group interviews with selected GPs, we will explore the following themes:
1. GPs perceptions of indicators of vulnerability in pregnant women
2. GPs’ perceived barriers and facilitators for assessing and addressing vulnerability in pregnant women
3. GPs’ perceived barriers and facilitators for collaborating in the cross sectoral antenatal care and for reporting on vulnerable pregnant women.
We develop an electronic questionnaire from the results of the qualitative studies. The aim of the questionnaire is to explore the following themes:
4. GPs’ perceived barriers of assessing vulnerable pregnant women and the associations with GP and practice characteristics (practice organization of antenatal care, GP age and seniority, practice type and localization)
5. GPs’ perceived barriers of collaborating and reporting and associations with GP and practice characteristics (practice organization of antenatal care, GP age and seniority, practice type and localization)

Project status
One qualitative study is published, with two more in review. We have developed the questionnaire, which is launched approximately at mid-October 2021.

Related publications (links)
Brygger Venø, L., Jarbøl, D., Pedersen, L. et al. General practitioners’ perceived indicators of vulnerability in pregnancy- A qualitative interview study. BMC Fam Pract 22, 135 (2021). https://doi.org/10.1186/s12875-021-01439-3

Updated: 4th October 2021