ORIGINAL ARTICLE  NEW INSIGHTS INTO MATERNITY CARE DESIGN AND DELIVERY 

Minerva Ginecologica 2018 December;70(6):650-62

DOI: 10.23736/S0026-4784.18.04301-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Optimal outcomes and women’s positive pregnancy experience: a comparison between the World Health Organization guideline and recommendations in European national antenatal care guidelines

Laura IANNUZZI ¹ ✉, Lucia BRANCHINI ², Jette A. CLAUSEN ³, Dolores RUIZ-BERDÚN ⁴, Patricia GILLEN ^{5, 6}, Maria HEALY ⁷, Katrien BEECKMAN ⁸, Anna SEIJMONSBERGEN-SCHERMERS ⁹, Ramon ESCURIET PEIRÓ ¹⁰, Sandra MORANO ¹¹, Mariarosaria DI TOMMASO ¹², Soo DOWNE ¹³

¹ Physiological Pregnancy Pathway and Margherita Birth Center, Department of Health Care Professions, Careggi University Hospital, Florence, Italy; ² MondoDonna Onlus, Association for Support and Integration of Immigrant Populations and Vulnerable Women, Bologna, Italy; ³ Department of Midwifery, University College Copenhagen, Copenhagen, Denmark; ⁴ Department of Surgery, Medical and Social Sciences, University of Alcalá, Alcalá de Henares, Spain; ⁵ Southern Health and Social Care Trust, Portadown, UK; ⁶ School of Nursing, Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK; ⁷ School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK; ⁸ Unit of Nursing and Midwifery Research, Faculty of Medicine and Pharmacy, Vrije Universiteit, Brussel, Belgium; ⁹ Department of Midwifery Science, Amsterdam Public Health Research Institute, Amsterdam UMC-VUmc, Amsterdam, The Netherlands; ¹⁰ Catalan Health Service, Generalitat de Catalunya, Barcelona, Spain; ¹¹ Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Infant Sciences (DINOGMI), University of Genoa, Genoa, Italy; ¹² Department of Science for Woman and Child Health, University of Florence, Florence, Italy; ¹³ Research in Childbirth and Health Unit (ReaCH), School of Community Health and Midwifery, University of Central Lancashire, Preston, UK

BACKGROUND: The publication of the World Health Organization (WHO) recommendations on antenatal care in 2016 introduced the perspective of women as a necessary component of clinical guidelines in maternity care. WHO highlights the crucial role played by evidence-based recommendations in promoting and supporting normal birth processes and a positive experience of pregnancy. This paper aims to explore and critically appraise recommendations of national antenatal care guidelines across European countries in comparison with the WHO guideline.
METHODS: We collected guidelines from country partners of the EU COST Action IS1405. Components of the documents structure and main recommendations within and between them were compared and contrasted with the WHO guideline on antenatal care with a particular interest in exploring whether and how women’s experience was included in the recommendations.
RESULTS: Eight out of eleven countries had a single national guideline on antenatal care while three countries did not. National guidelines mostly focused on care of healthy women with a straightforward pregnancy. The level of concordance between the national and the WHO recommendations varied along a continuum from almost total concordance to almost total dissonance. Women’s views and experiences were accounted for in some guidelines, but mostly not placed at the same level of importance as clinical items.
CONCLUSIONS: Findings outline convergences and divergences with the WHO recommendations. They highlight the need for considering women’s views more in the development of evidence-based recommendations and in practice for positive impacts on perinatal health at a global level, and on the experiences of each family.

KEY WORDS: Prenatal care - Guideline - Pregnancy - Midwifery - World Health Organisation