Health literacy and patient understanding of first and second trimester screening for aneuploidy and neural tube defects

Abstract

REMOORTERE, JUAN E. VARGAS, ALVARO INSUNZA, RICARDO GOMEZ, LUIS MEDINA, AARON B. CAUGHEY, University of California, San Francisco, Obstetrics, Gynecology and Reproductive Sciences, San Francisco, California, Clinica Alemana de Santiago, Hospital Padre Hurtado, Universidad del Desarrollo, Santiago, Chile, CEDIP, Sotero del Rio Hospital, Puente Alto, Chile OBJECTIVE: The literature has shown that women perceive their birth experience very differently depending on mode of delivery, prenatal care, and the amount of education they receive prior to delivery. Here we investigate how complications in prior pregnancies or a current high-risk pregnancy might influence birth experience as well. STUDY DESIGN: Pregnant women were surveyed in regular and high-risk prenatal clinics in Santiago, Chile over a six month period. They were interviewed regarding prior deliveries and outcomes, their anticpated birth experience during the upcoming delivery, and the maximum amount of pain they expected to feel. Dimensions of birth experience were assessed by Salmon’s item list and measured using a 10 point Likert scale. RESULTS: Of the 643 women surveyed, 152 (23.6%) were patients with high-risk pregnancies and 491 (76.4%) had normal pregnancies. When comparing women with a history of prior complications to those with a history of normal pregnancies, there was no significant difference in the amount of satisfaction or pain anticipated. They did, however, expect to be more anxious (8.08 versus 6.89, p=0.039). Patients with current high-risk pregnancies did not expect more pain, but they anticipated more anxiety (7.62 versus 6.63, p=0.021) and more satisfaction (9.13 versus 8.74, p=0.009). CONCLUSION: Patient’s with a current high-risk pregnancy or a history of complications during a prior pregnancy do not anticipate more pain during delivery, but they do feel more anxious. Interestingly, patients with current high-risk pregnancies also expect more satisfaction with their delivery. These data suggest that women with high-risk pregnancies may actually have more fulfilling birth experiences than women with normal pregnancies.