Influence of provider communication on women’s delivery expectations and birth experience appraisal: A qualitative study

BACKGROUND AND OBJECTIVES: Although current research suggests that patient-provider prenatal communication and expectation- setting affects women’s outcomes, more needs to be understood about the kinds of communication experiences that shape women’s expectations, the nature of expectations that women hold, and how those expectations influence their appraisal of labor and delivery. The goal of this study is to draw connections between provider communication, birth experience expectations, and birth experience appraisals. METHODS: Recently delivered mothers (n=36) were recruited at a mid-Atlantic community hospital. Using a grounded theory approach, interviews were systematically analyzed to uncover how participants perceived provider communication during their prenatal care, how participants described their expectations of the birth experience, and how expectations affected appraisals of the experience. RESULTS: Mothers recognize providers’ use of patient-centered communication in messages of empowerment, emotional support, explanation, decision making, and elicitation. Findings posit that it is the inflexibility or flexibility of expectations that may determine mothers’ appraisals of the birth experience. CONCLUSIONS: Mothers continue to rely on providers as partners in health care. Through patient-centered communication, providers can help mothers develop flexible expectations of the birth experience, which in turn can result in positive appraisals of delivery.