Referral and attendance at a specialist antenatal clinic: qualitative study of women’s views

Objective To explore women’s views on being referred to and attending a specialist antenatal hypertension clinic. Design Qualitative interview study. Setting A pregnancy hypertension clinic in a large teaching hospital in the East Midlands. Population Twenty‐one women (aged 18 years and above) attending the pregnancy hypertension clinic for the first time during their current pregnancy. Methods Women who had been referred to and attended a specialist antenatal clinic participated in semi‐structured interviews. Data analysis was based on the constant comparative method. Main outcome measures Women’s experiences and perceptions of being referred to and attending a specialist antenatal clinic. Results Being referred to the clinic conferred an ‘at risk’ status on women. Some women welcomed the referral but others experienced it as unsettling. Many were unclear about why they had been identified as being at risk or had difficulties in accepting the legitimacy of the reason for referral. Women were often inadequately informed about why they were referred to the clinic, what they could expect and the benefits of attending the clinic over management in the community. Although attendance at the clinic was cited as a source of reassurance, the reassurance was often made necessary by concern raised by the initial referral. Conclusions Women’s accounts suggest that the interface between community and secondary antenatal services needs improvement to minimise possible adverse effects from identifying women as being ‘at risk’ during pregnancy.