Pregnant women's perceptions of antenatal care in a specialised mobile health unit (Opti’care) in rural municipalities: the PERCEP’Care qualitative study

Background This study is a component of the Opti’care project — a mobile clinic intended for pregnant women living in remote rural municipalities covered by the regional of Auvergne perinatal network to promote their access to antenatal care throughout pregnancy. To characterise the favourable and unfavourable perceptions of women using the Opti’care services in phase 1 (trimester 1), phase 2 (trimesters 2 and 3) and phase 3 (≥ 6 weeks postpartum). Methods This study was cross-sectional and qualitative. It took place among pregnant and postpartum women using the Opti’care mobile clinic in 4 French districts in the region of Auvergne-Rhône-Alpes (AURA, France. Semi-directive interviews using the e.Photoexpression© tool as support were conducted to obtain the perceptions of pregnant women about the services provided by Opti’care at each phase of the study. The qualitative analysis of the data was performed by categorising the units of meaning derived from the content analysis. We conducted a statistical analysis of this categorisation. Results The results of this study allowed us to model the perceptions of 50 pregnant women about the Opti’care services through the analysis of 35 dimensions: 19 dimensions of favourable perceptions and 16 dimensions of unfavourable perceptions. We observed changes in these perceptions across the 3 phases. In phase 1, the women's discourse focused mostly (80%) on the proximity of access to care. During phase 2, they mentioned in priority (49%) the team's positive personal and human qualities. In phase 3, they spoke most about the quality of the follow-up, which was appropriate to their needs (59%). The unfavourable perceptions were associated mainly with the fears linked to their lack of knowledge about this mobile clinic at the beginning of the pregnancy; these faded over time and were not replaced by any other unfavourable feelings. Conclusions This study revealed that the multidisciplinary support provided by the Opti’care programme offered an individualised and personalised follow-up, focused on the real needs of the pregnant women living in rural municipalities and thus responded to this major public health issue. Trial registration : The Patient Protection Committee North-West II approved this study on February 04, 2021 (IRB 2020-A02247-32). The protocol was registered as Clinical Trial NCT04823104 on March 30, 2021. All women included in the study consented in writing to participate.