title: What matters to women: a systematic scoping review to identify the processes and outcomes of antenatal care provision that are important to healthy pregnant women.
abstract: BACKGROUND
  Global uptake of antenatal care (ANC) varies widely and is influenced by the value women place on the service they receive. Identifying outcomes that matter to pregnant women could inform service design and improve uptake and effectiveness.
  
  
  OBJECTIVE
  To undertake a systematic scoping review of what women want, need and value in pregnancy.
  
  
  METHODS
  Eight databases were searched (1994-2015) with no language restriction. Relevant journal contents were tracked via Zetoc.
  
  
  METHODS
  An initial analytic framework was constructed with findings from 21 papers, using data-mining techniques, and then developed using meta-ethnographic approaches. The final framework was tested with 17 more papers.
  
  
  RESULTS
  All continents except Australia were represented. A total of 1264 women were included. The final meta-theme was: Women want and need a positive pregnancy experience, including four subthemes: maintaining physical and sociocultural normality; maintaining a healthy pregnancy for mother and baby (including preventing and treating risks, illness and death); effective transition to positive labour and birth; and achieving positive motherhood (including maternal self-esteem, competence, autonomy). Findings informed a framework for future ANC provision, comprising three equally important domains: clinical practices (interventions and tests); relevant and timely information; and pyschosocial and emotional support; each provided by practitioners with good clinical and interpersonal skills within a high quality health system.
  
  
  CONCLUSIONS
  A positive pregnancy experience matters across all cultural and sociodemographic contexts. ANC guidelines and services should be designed to deliver it, and those providing ANC services should be aware of it at each encounter with pregnant women.
  
  
  CONCLUSIONS
  Women around the world want ANC staff and services to help them achieve a positive pregnancy experience.
authors.affiliation: Research in Childbirth and Health (ReaCH) group, University of Central Lancashire, Preston, UK.
authors.forename: S
authors.initials: S
authors.lastname: Downe
authors.affiliation: Research in Childbirth and Health (ReaCH) group, University of Central Lancashire, Preston, UK.
authors.forename: K
authors.initials: K
authors.lastname: Finlayson
authors.affiliation: Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
authors.forename: Ӧ
authors.initials: Ӧ
authors.lastname: Tunçalp
authors.affiliation: Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Metin Gülmezoglu
mesh_terms: D000328:Adult; D003153:Community Health Services; D005260:Female; D014943:Global Health; D006801:Humans; D000068101:Maternal-Child Health Services / Q000458:organization & administration* / Q000592:standards; D020380:Needs Assessment / Q000458:organization & administration*; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D037841:Pregnant People / Q000523:psychology*; D011295:Prenatal Care / Q000458:organization & administration* / Q000592:standards
keywords: Antenatal care; World Health Organization; guidelines; pregnancy; social support; women's views; wordclouds