Delivering care under uncertainty: Swiss providers’ experiences in caring for women with spinal cord injury during pregnancy and childbirth – an expert interview study

BMC Pregnancy and Childbirth, 2016 · DOI: 10.1186/s12884-016-0976-y · Published: July 16, 2016

Spinal Cord Injury Healthcare Women's Health

Simple Explanation

This study explores the challenges healthcare providers in Switzerland face when caring for pregnant women with spinal cord injuries (SCI). These women may experience unique medical issues requiring expertise from different specialties. The research involved interviewing fifteen healthcare professionals from various fields to understand their experiences and perceptions in providing care to this specific patient population. The study used grounded theory techniques to analyze the interview data. The study found that healthcare providers often feel uncertain when caring for pregnant women with SCI due to the complexity and rarity of these cases. This uncertainty can lead to different approaches in care, highlighting the need for better interdisciplinary collaboration and specific guidelines.

Study Duration

May to September 2014

Participants

15 health professionals (gynaecologists, midwives, physical medicine and rehabilitation professionals, urologists, and a peer counselor)

Evidence Level

Not specified

Key Findings

1
The study identified 'care delivery under uncertainty' as a core challenge for health professionals caring for pregnant women with SCI, due to the rarity of such cases and lack of specialized resources.
2
Health professionals exhibited three different attitudes when handling these situations: a protective concerned attitude, a 'no big deal' attitude, and a precautionary attitude.
3
The healthcare professionals expressed a need for more specific services, information, guidance, and guidelines tailored to caring for women with SCI during pregnancy and childbirth.

Research Summary

The study investigates the experiences of Swiss healthcare providers in caring for pregnant women with spinal cord injuries (SCI). It identifies challenges related to uncertainty, lack of specific guidelines, and the need for interdisciplinary collaboration. The research highlights the varying attitudes and approaches adopted by healthcare professionals, including protective, nonchalant, and precautionary stances, influenced by the healthcare system and individual behaviors. The study concludes with a call for more specific services, information, and guidelines for health professionals, emphasizing the importance of further research and the development of integrated care concepts to improve outcomes for pregnant women with SCI.

Practical Implications

Development of Specific Guidelines

Create specific guidelines and protocols for managing pregnancies in women with SCI to reduce uncertainty and improve care quality.

Enhance Interdisciplinary Collaboration

Promote and facilitate interdisciplinary collaboration among healthcare professionals from different specialties to provide holistic care.

Establish Centers of Excellence

Consider establishing specialized centers or reference points for collecting and disseminating knowledge about pregnancy in women with SCI.

Study Limitations

1
The qualitative methodology may limit the generalizability of the findings.
2
The small sample size does not allow for substantive comparisons between professional groups.
3
The sampling strategy may have excluded certain perspectives from other healthcare professionals, such as family doctors and neurologists.

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