Women’s Satisfaction With the Current State of Prenatal Care for Pregnancies Complicated by Fetal Anomalies: A Survey of Five Academic Perinatal Units in Ontario

Abstract Objective To assess women’s satisfaction with the current state of prenatal care for pregnancies complicated by congenitalanomalies. Methods We conducted a cross-sectional survey of 251 women with pregnancies complicated by congenital anomalies. The women were recruited from five Ontario hospitals (Mount Sinai Hospital in Toronto, Hamilton Health Sciences Centre, St. Joseph’s Health Care in London, Kingston General Hospital, and The Ottawa Hospital) at the time of referral. A seven-question, self-administered questionnaire developed by an expert panel was used to collect data from the study subjects about satisfaction with prenatal care at antenatal clinics. The women’s level of satisfaction was measured using a 5-point scale (1 = least satisfactory and 5 = most satisfactory). Demographic information and information about women’s medical and obstetrical history, and obstetrical knowledge was also collected. Descriptive analyses were performed, and relative risks (RR) were calculated to estimate measures of association. Results Most of the study subjects (> 90%) had a high level of education and were married or in a common-law relationship, and about 80% came from high-income families. The mean age of the study subjects was 31.4 years. The mean gestational age at the first visit with a doctor or midwife was 8.5 weeks, at first being told of a concern with their pregnancy was 18.6 weeks, and at the first visit with an obstetric specialist in the community was 19.6 weeks. Mean scores for each item of satisfaction measure varied from 4.05 to 4.53, and the mean score for women’s overall satisfaction was 29.7 (95% confidence intervals [CI] 28.9–30.4). There was a statistically significant association between women’s opinion and knowledge of prenatal testing and their level of satisfaction with prenatal care. Women who had difficulty understanding what a doctor or midwife was telling them were less satisfied with prenatal care than women without such difficulty (RR 3.21; 95% CI 2.14–4.81). Language and ethnic diversity were not associated with the level of satisfaction. Conclusion In Ontario, of women whose pregnancies are complicated by congenital anomalies, those who are less knowledgeable about their pregnancies are more likely to be dissatisfied with their prenatal care. Overall, however, most women are satisfied with their prenatal care.