Women's responses to two models of antepartum high-risk care: Day stay and hospital stay

Abstract

Aim

To replicate and extend previous research by examining women's responses to two current models of high-risk antenatal care that replaced the traditional bed rest model.

Participants

A sample of 61 women assigned to high-risk antenatal care: 29 in the Antenatal Hospital Unit (ANHU) and 32 in the Pregnancy Day Stay Unit (PDSU).

Methods

A longitudinal study with data collected by a range of validated tools were used to assess mood, family functioning, stress and physical symptoms every 2 weeks from admission into antenatal high-risk care to birthing and at 3- and 6-weeks postpartum. Data were analysed for similarities and differences and change over time between the two groups of women.

Findings

Stress from emotions was the highest antenatal stressor for both groups and highest for those in hospital. Stress about health increased over time for those in the PDSU and varied for those in ANHU. Anxiety was significantly different between the groups over time (p < 0.01), being highest for the ANHU group and decreasing from admission to 6-weeks postnatal for both groups. Sensation Seeking (sensory deprivation) showed significant differences (p < 0.05) with the highest scores in the ANHU group and increasing over time for both groups. Family relationships were most disrupted for those in ANHU. Both groups were satisfied with support from spouse, family and friends and those in ANHU acknowledged the support received from midwifery staff.

Conclusions and implications

The responses of both the woman and her family differ between the two models of care and vary with time. Midwives can use the patterns of response identified of these findings to address needs for assistance with family relationships, sensory stimulation, information and support and management of anxiety when care is required for complications of pregnancy.