Women's perceptions of outcomes of prenatal case management.

Abstract

Comprehensive case management is a multidisciplinary, community-based service often available to Medicaid-eligible women. The purpose of the study was to identify the variety of maternal outcomes, other than birth outcomes, attributable to comprehensive prenatal case management. This qualitative study used a social ecological approach. Twenty-four women were interviewed about the outcomes they experienced as a result of comprehensive prenatal case management. Ethnographic content analysis was used for data reduction. The participants' mean age was 25.4 (SD = 8.4) years, with an average parity of 1.9 (SD = 1.1). Fifteen participants (68%) had a 12th grade education or less. Ethnic minorities were included in the sample. Eleven participants (47%) worked at least part-time, although 23 (98%) were receiving Medicaid and 21 (88%) were receiving the Women, Infants, and Children's (WIC) supplementary nutrition program. The women attributed improvements of various types to the actions of the case manager, specifically in the areas of emotional well-being, learning, lifestyle behaviors, financial situation, services utilization, and maternal and infant physical health. Case management appeared to have immediate effects on the women, as well as intermediate effects, such as changes in lifestyle behaviors and services utilization. The women attributed those changes to having a healthy pregnancy.