Women's maternity and birth experiences in the PREVENT-PE trial: A qualitative investigation.

Background: Pre-eclampsia (PE) continues to be a major risk to maternal and fetal health, complicating up to 5% of all pregnancies, with no proven pharmacological intervention to reduce its incidence at term. Screening for pre-eclampsia risk at 35–36 weeks' gestation has been associated with a 30% reduction in the incidence of the primary outcome of PE, in The PREVENT-PE Trial. Methods: We aimed to understand women's maternity and birth experiences in The PREVENT-PE Trial. Semi-structured interviews were conducted with women (N = 80) from The PREVENT-PE Trial including those who were screened and had a timed birth (n = 37); those who were randomised to usual care (n = 31); and those who declined randomisation (n = 12). Data were subjected to a Template Analysis, based on findings from previous studies on maternity care experiences. Findings: We report on four key themes: Achieving Efficiencies with Research-embedded Clinical Care; Communicating Trial Information; Building Relationships with Care Providers; and Agency and Shared Decision-making. Maternity service delivery was deemed to be efficient as was the care they received during the trial. Volume of complex medical information caused concern; however, regular, consistent contact between women and their healthcare providers, helped women feel valued and understood; especially when they were provided with the opportunity to ask questions and have them answered. Conclusion: Participation in an intervention trial within maternity care should embed principles of effective communication, relational care, shared decision-making, and efficient service delivery. Addressing these with not only enhance maternal experience but may also further promote greater participation in research.