title: Client perspectives of midwifery care in the transition from subfertility to parenthood: a qualitative study in the Netherlands.
abstract: BACKGROUND
  Pregnancy, childbirth and the postpartum period after fertility treatment are considered "normal" in the Netherlands, with no indication of an increased obstetric risk, and can therefore be monitored by a primary care midwife. However, there is little evidence on the experiences of couples and women who finally get pregnant after fertility treatment and a lack of training for midwives exists on this subject. The aim of this study was to map the midwifery care needs of the subfertile client with past fertility problems.
  
  
  METHODS
  In 2011, we interviewed two couples and seven women who conceived through fertility treatment and received primary midwifery care at some point during their pregnancies. This explorative, qualitative study was based on the interpretivist/constructivist paradigm.
  
  
  RESULTS
  Although the participants are not representative of all subfertile clients, the findings of our qualitative study highlight the needs of women and their partners who have become pregnant through fertility treatment including help from the primary care midwife in understanding the likely course of their pregnancy, more psychosocial support and acknowledgement of the fertility treatment history, and more consultations and frequent ultrasound scans than usual to confirm pregnancy.
  
  
  CONCLUSIONS
  Our study points out that the women who have become pregnant through fertility treatment and their partners communicate seemingly paradoxical prenatal care needs. It can help maternity care providers to optimally meet the care needs of subfertile clients and empower them during their transition from subfertility to parenthood.
authors.affiliation: a Midwifery Academy Amsterdam-Groningen, Dirk Huizingastraat , Groningen , The Netherlands .|b Department of Midwifery Science , AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands .
authors.forename: J Catja
authors.initials: JC
authors.lastname: Warmelink
authors.affiliation: a Midwifery Academy Amsterdam-Groningen, Dirk Huizingastraat , Groningen , The Netherlands .|c Midwifery practice Leeuwarden , The Netherlands , and.
authors.forename: Wietske
authors.initials: W
authors.lastname: Adema
authors.affiliation: a Midwifery Academy Amsterdam-Groningen, Dirk Huizingastraat , Groningen , The Netherlands .|d Midwifery practice Dokkum and Drachten , The Netherlands.
authors.forename: Annelies
authors.initials: A
authors.lastname: Pranger
authors.affiliation: a Midwifery Academy Amsterdam-Groningen, Dirk Huizingastraat , Groningen , The Netherlands .|b Department of Midwifery Science , AVAG and the EMGO Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands .
authors.forename: T Paul
authors.initials: TP
authors.lastname: de Cock
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008880:Midwifery / Q000458:organization & administration*; D009426:Netherlands; D024802:Nurse's Role; D016487:Parenting / Q000523:psychology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011295:Prenatal Care / Q000523:psychology*; D036301:Qualitative Research; D027724:Reproductive Techniques, Assisted / Q000451:nursing* / Q000523:psychology*
keywords: Assisted reproductive technologies; coping with the aftermath of infertility; midwifery; pregnancy; qualitative methods