Experiences of group antenatal care in the context of the NHS in England: what are the mechanisms by which it functions in this context?

作者：Christine McCourt, Anita Mehay, Octavia Wiseman, Jalana Lazar, Ruth Ajayi, Thomas Hamborg, Vivian Holmes, Rachael Hunter, Ekaterina Mishareva, Pearl Safo Sobre, Meg Wiggins, Angela Harden, Cathy Salisbury, Bethan Hatherall · 发表于：Frontiers in Global Women s Health · 年份：2025 · DOI：10.3389/fgwh.2025.1625785 · 被引用次数：1 · 研究领域：Maternal and Perinatal Health Interventions、Global Maternal and Child Health、Maternal Mental Health During Pregnancy and Postpartum

Introduction: Group antenatal care is a model where care is provided in groups of around 6-12 women/birthing people, integrating healthcare with information and learning in a participatory approach. There is international evidence of improved care experiences and outcomes; however, the approach (here called Pregnancy Circles) had not been trialled in the United Kingdom in the context of a universal health system with midwife-led care. We aimed to understand the experience of care and any mechanisms by which group care functions for the different people involved. Method: This study comprised a qualitative process evaluation nested within a randomised controlled trial. The mixed qualitative methods used in this study included observations of care, interviews with participants, survey open-text responses and written feedback, and a review of relevant documents. Inductive thematic analysis was conducted using a framework of theorised mechanisms based on a realist review. The trial's clinical and psychosocial outcomes and lessons for implementation are reported elsewhere. Results: We found a high level of concordance with the framework of mechanisms derived from the literature. The key mechanisms were social support and community building, a critical pedagogy (combining peer learning, an interactive and participatory approach, and health education), satisfaction and engagement with care, and the health professionals' satisfaction and development. Building on these, the empowerment...