Mixed-method study on internet use and information-seeking during transition to motherhood

Abstract

Abstract Background Traditional approaches to antenatal education have been questioned as to their effectiveness. The use of the internet for information-seeking is very prevalent, however sources are of varied quality. We explored the information-seeking behaviour of pregnant women in the context of health literacy skills and informed decision-making. Methods In a mixed-method descriptive study, 12 focus groups with a culturally diverse set of pregnant women and new mothers (N = 62), a non-participant observation study of antenatal education classes and a web-based questionnaire survey were performed (N = 200). The survey explored use and critical appraisal of internet sources of information, perceived role in assisting decision-making, user-provider interaction, alliance and autonomy in decision making. Results Six themes emerged: in a generally “unsupportive system”, pregnant women want to have a “confident voice” but find themselves “self-navigating” in parallel worlds of formal and informal information, using a process of “supplementing and filtering”, sometimes instinctively and selectively, ending up in a state of “doubt and faith” with regards to the trustworthiness of the information and physician dominance in communication, while the “art of communication” is essential to break the cycle. Internet information-searching is very prevalent, even though 60% characterize the information as misleading and 90% would like health professionals to recommend trusted sites. While the majority report discussing this information with their healthcare providers, only 57% characterize the reception as positive. Conclusions Women want to have control over decisions affecting their pregnancy. While the internet is a prevalent information source, they value the communication with their healthcare providers and want direction. Maternity healthcare professionals need to recognize the phenomenon, offer appropriate guidance and support shared decision-making. Key messages “Traditional” antenatal education arrangements are not effective in supporting informed decision-making. In a landscape of prevalent internet use, a shift is needed from current practices of unguided information-searching.