title: A public health perspective of women's experiences of antenatal care: an exploration of insights from a community consultation.
abstract: OBJECTIVE
  to offer a critical discussion from a public health perspective of service user's experiences of antenatal care services.
  
  
  METHODS
  a qualitative, descriptive study using 18 group (n = 86) and six individual semi-structured interviews (n = 6) with thematic networks analysis conducted.
  
  
  METHODS
  ninety-two participants recruited from organisations/groups who work with vulnerable populations and/or community groups were consulted in the North West of England.
  
  
  RESULTS
  analysis from a public health perspective suggested four key areas: antenatal care attendance, the frequency of antenatal appointments, the location of antenatal care and the provision of risk information. The benefits of universal access to antenatal care were mainly evident to participants. The need for targeting those with identified clinical risk was valued, but participants expressed frustration at a 'one-size fits all' approach for others, which failed to adequately consider their psychosocial and educational needs. In some women, this failure prompted non-compliant behaviour. Concerns were somewhat compensated for by community-based antenatal services.
  
  
  CONCLUSIONS
  inequities in antenatal care persist with service users from vulnerable population groups continuing to express that these services do not meet their needs. Neither a targeted approach based on clinical needs nor a population-based approach, which service users feel limits access, meet their expectations. Proportionate universalism offers a new paradigm in public health with level of service proportionate to need. Such an approach may facilitate health-care staff to meet the expectations of vulnerable families who may require more psychosocial and educational support.
authors.affiliation: Maternal and Infant Nutrition and Nurture Unit, School of Health, Brook Building, University of Central Lancashire, Preston PR1 2HE, UK. GThomson@uclan.ac.uk
authors.forename: Gill
authors.initials: G
authors.lastname: Thomson
authors.forename: Fiona
authors.initials: F
authors.lastname: Dykes
authors.forename: Gulab
authors.initials: G
authors.lastname: Singh
authors.forename: Lucinda
authors.initials: L
authors.lastname: Cawley
authors.forename: Paola
authors.initials: P
authors.lastname: Dey
mesh_terms: D000328:Adult; D003256:Community Participation / Q000379:methods / Q000706:statistics & numerical data; D054626:Consumer Health Information / Q000379:methods / Q000592:standards; D003710:Demography; D004739:England; D005260:Female; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D008427:Maternal Health Services / Q000379:methods / Q000592:standards; D020380:Needs Assessment; D057240:Patient Preference / Q000706:statistics & numerical data*; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D011295:Prenatal Care / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D064186:Prenatal Education; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D035862:Vulnerable Populations / Q000523:psychology / Q000706:statistics & numerical data