Survey of maternal anxiety and perceptions towards foetal MRI and pre‐scan education

Abstract

Introduction

Foetal MRI scans can induce feelings of fear, concern and anxiety in pregnant patients. The aim of this research was to determine if providing patients with an information leaflet reduced maternal anxiety regarding foetal MRI.

Methods

A prospective, three‐arm comparative pilot study was performed in the MRI department of a quaternary public hospital in Brisbane, Australia. Three groups of 30 participants (total 90 participants) received differing levels of information about foetal MRI: Group A – no foetal‐MRI specific information (current practice at the site); Group B – a basic information leaflet; Group C – a comprehensive information leaflet. All participants completed a survey that explored their pre‐scan anxiety immediately after their MRI scan.

Results

Over 50% of participants in each group felt anxious before the MRI. Participants expressed anxiety towards the general process of the MRI, the outcome or results of the scan, and the safety of the modality. The basic and comprehensive leaflets were both efficacious in reducing anxiety for the majority of participants.

Conclusions

Whilst not all patients express anxiety regarding MRI scans, emotional distress surrounding the entire process is prevalent. Providing patients with comprehensive information about what the MRI scan entails (including the scan environment and duration, positioning, breath‐holding requirements, and foetal safety) reduces anxiety for most patients. These findings can be used to determine ways in which reduction of anxiety improves the patient experience.

Foetal MRI scans can induce feelings of fear, concern and anxiety in pregnant patients. A prospective, three‐arm comparative pilot study was performed to determine if providing patients with an information leaflet reduced maternal anxiety regarding foetal MRI. Whilst not all patients expressed anxiety regarding the MRI scan itself, emotional distress surrounding the entire process was prevalent and information leaflets helped to reduce this.

Introduction

For decades, ultrasound (US) was the principal modality for foetal imaging. However, due to technological advances, magnetic resonance imaging (MRI) has become an established imaging modality in antenatal care. ¹ , ² , ³ , ⁴ , ⁵ , ⁶ Foetal MRI can lead to changes in clinical management due to its increased diagnostic accuracy compared to US, particularly for foetal brain abnormalities. ⁷ , ⁸ , ⁹ Undergoing the pre‐natal diagnostic journey can cause patients to experience a range of emotions, and an adverse pre‐natal diagnosis can cause significant psychological distress. ¹⁰ , ¹¹ , ¹² , ¹³ Additionally, anxiety surrounding the MRI scan itself can lead to reduced patient cooperation (or complete refusal), ¹⁴ , ¹⁵ reduced image quality, ¹⁵ early termination of exams or incomplete imaging, ¹⁴ , ¹⁶ , ¹⁷ all of which can influence patient outcome, diagnosis, treatment and patient/clinician satisfaction. ¹⁸

Most women are generally accepting of routine pre‐natal US imaging and have positive feelings towards the imaging process. ¹⁹ The foetal MRI imaging process, on the other hand, can be very demanding for women. Major factors that induce stress and anxiety for mothers during a foetal MRI include concern for the foetus, the potential diagnosis, unexpected and loud noises from the scanner, physical restraint from the MRI coils, claustrophobia, agitation of the foetus and the duration of the MRI scan. ²⁰ , ²¹ Since these stressors can influence the success of the MRI and patient satisfaction, women should be provided with appropriate education and support. Forshaw et al. ²² suggest that supplying patients with procedural, sensory and behavioural information may reduce anxiety regarding medical imaging scans. Previous studies have also discussed the benefit that pre‐education has on the anxiety of patients undergoing MRI scans. ⁴ , ²⁰ , ²¹ , ²³

Aim

There are barriers to pre‐scan briefing in busy departments where allocation of time to communicate with individual patients is limited. ²⁴ An information leaflet is a direct method of patient education that may improve women's understanding of foetal MRI. ²¹ , ²⁵ It is theorised that providing patients with a comprehensive information leaflet will help reduce maternal anxiety surrounding foetal MRI and the aim of this research is to determine this. This study will highlight the areas of MRI women feel anxiety towards and will help distinguish whether more detailed information leaves mothers feeling better educated, and therefore, less anxious.

Methods

Design

This prospective, three‐arm comparative pilot study examined whether an information leaflet reduced levels of anxiety in women undergoing foetal MRI scans. To help distinguish the level of education patients prefer, the study involved three groups receiving differing levels of information: Group A (control group, n = 30) – participants received no foetal MRI‐specific education prior to the foetal MRI, Group B (n = 30) – participants received a basic information leaflet prior to the MRI and Group C (n = 30) – participants received a comprehensive information leaflet prior to the MRI (see Appendices S1 and S2). The questionnaires included qualitative and quantitative components, asking participants about multiple aspects of foetal MRI. Questions were developed in collaboration with a senior MRI radiographer and were based on patient expectations, anxiety levels regarding different aspects of the foetal MRI, what could have helped their anxiety and the impact the information leaflet had on anxiety (for Group B and Group C only). This research project was conducted at a single, quaternary hospital in Brisbane, Australia. Group A reflected the current practice at the study site.

Ethics

Ethical approval for this research project was granted by the Royal Brisbane & Women's Hospital Human Research Ethics Committee (HREC/2020/QRBW/63050). All eligible participants were provided with a study information and consent form. Written consent was obtained prior to inclusion in the study. Written consent was also obtained from the model in the photographs included in the comprehensive information leaflet.

Participants

Eligible participants were pregnant women aged 18 and over who were referred for a foetal MRI (at any gestation), who were able to give written consent and were willing to comply with study requirements. Potential participants were identified through the hospital site radiology information system (RIS). Recruitment began in June 2020 and concluded in April 2021. The sample size was set to n = 90 (30 participants per group), which exceeds the pilot study sample size recommended by Julious ²⁶ and Sim and Lewis. ²⁷

Procedure

The RIS was monitored daily by the primary researcher for foetal MRI examinations booked for the following business day. Women aged 18 and over received a scripted phone call the day before their appointment to introduce them to the study. This phone call enabled the researcher to explain the aims of the study and confirm the appointment arrival time. A member of the research team or a MRI staff member provided the patient with a participant information sheet and consent form upon their arrival to the department. If the patient gave their written consent to being involved, they were allocated to either Group A, Group B or Group C. Allocation alternated between groups (i.e. A – B – C – A – B – C – etc.). Participants were blinded to the groups, however, the researchers and MRI staff were not. A study number was given to each participant to allow for re‐identification of data in the case of withdrawals. Participants allocated to Group A did not receive an information leaflet before their MRI, Group B participants received a basic information leaflet prior to their MRI and Group C participants received a more comprehensive information leaflet prior to their MRI. The information leaflets were developed by the research author in collaboration with a senior MRI radiographer with over 10 years' experience in foetal MRI. The basic leaflet was a one‐page document containing a brief, text‐only explanation of the examination under the headings: ‘What is a foetal MRI?’, ‘What to expect’ and ‘Risks of a foetal MRI’. The comprehensive information leaflet was a two‐page document, containing more detailed explanation of the topics covered in the basic leaflet under the headings: ‘What is a foetal MRI?’, ‘What to expect before a foetal MRI’, ‘What to expect during a foetal MRI’, ‘What to expect after a foetal MRI’, ‘Risks of a foetal MRI’ and ‘Frequently asked questions’. The comprehensive information leaflet also contained photographs of the MRI machine and patient positioning. As per the normal MRI booking process, patients were asked to arrive 30 min prior to their scan to allow time to get changed and fill out the safety questionnaire. Part of this 30‐min timeframe was used for Group B and Group C participants to read their respective information leaflets. Being a busy department managing both inpatient and outpatient bookings, it was difficult to ensure a specific and standardised time was given to all participants to read the leaflets. Albeit this, researchers and MRI staff were asked to give participants additional time if necessary to ensure the information leaflet was read in full before their scan. Following the foetal MRI, a research team member or MRI staff member provided participants with a questionnaire to complete (participants in all groups completed a questionnaire).

Measure

Questionnaires used in this study were developed by the primary researcher and included basic demographic and multi‐choice questions, open‐ended questions, and 5‐point Likert scale questions (1 – strongly disagree, 2 – disagree, 3 – neutral, 4 – agree, 5 – strongly agree). Questions were developed in collaboration with a senior MRI radiographer and were based on patient expectations, anxiety levels regarding different aspects of the foetal MRI and the impact the information leaflet had on anxiety (for Group B and Group C only). The questionnaires were not validated, however, they were reviewed and revised by multiple members of the research team to ensure easy understanding and timely completion.

Analysis

Responses from demographic and multi‐choice questions were analysed and presented as percentages. SPSS Version 23 (IMB Corp. Released 2015. Armonk, NY: IBM Corp.) was used to statistically analyse data from the Likert scale questions. A traditional 5‐point Likert scale was included in the questionnaires as the authors felt that this was most common and would be easily recognisable to participants. This introduced a level of complexity in the analysis stage that the authors deemed unnecessary, therefore, answers were grouped into agree, disagree and neutral. Chi‐square and Fisher's Exact tests were used for the analysis (Fisher's Exact test used when >20% of cells had an expected count less than five) – Bewick, Cheek, and Ball ²⁸ discuss the appropriateness of this method. Statistical significance was set to P < 0.05. Thematic content analysis was undertaken for open‐ended questions using the guide published by Braun and Clarke. ²⁹

Results

Ninety‐seven patients were consented for the study. Seven participants were excluded from the study (five of these did not complete the survey, one stated they did not receive an information leaflet, and one signed the consent & withdrawal form). Of the 90 participants included in this study, the average age was 30.6 years (range 19–50 years). The average age of participants in Group A, Group B and Group C showed no statistical difference (P = 0.545). Approximately 30–40% of patients had experienced an MRI scan before, however, less than 10% of participants in each group had experienced a foetal MRI scan (Table 1).

Table 1.

Cohort information.

	Group A	Group B	Group C
	n (%)	n (%)	n (%)
	n = 30	n = 30	n = 30
Age (mean ± SD)	30.9 ± 5.48 years	31.27 ± 6.83 years	29.57 ± 6.34 years
Participants who had undergone MRI in the past	9 (30%)	9 (30%)	12 (40%)
Participants who had undergone a foetal MRI scan in the past	2 (7%)	2 (7%)	2 (7%)

SD, standard deviation.

First, our team assessed the baseline anxiety levels across each group using Likert‐scale questions. General anxiety was gauged with the question ‘I generally feel anxious’. Then we asked participants more directed questions specific to the MRI: ‘I felt anxious before the scan’, ‘I felt anxious during the scan’, ‘I felt anxious about the outcome’ and ‘I was anxious about the safety for my baby’. The rationale of including a question regarding safety was based on consultation with MRI team members and previous anecdotes. Some patients prior to this study had expressed concern regarding the safety of MRI for their child and were worried about radiation and/or injections. The research team felt it was important to explore this aspect further.

There was a statistically significant difference in baseline anxiety between groups (Likert question 1: ‘I generally feel anxious’) (χ²(2) = 16.5, P = 0.002). Only 7% (n = 2/30) of participants in Group A felt general anxiety, whilst Group B (13%, n = 4) and Group C (47%, n = 14) indicated that they felt higher levels of normal anxiety (Fig. 1a). There was also a statistically significant difference between groups in regards to Likert question 2 (Fig. 1b): ‘I felt anxious before the scan’ (χ²(2) = 11.3, P = 0.024). In Group A and Group B, 50% (n = 15) and 57% (n = 17) of participants, respectively, agreed (or strongly agreed) with the aforementioned statement. In comparison, 77% (n = 23) of participants in Group C agreed (or strongly agreed) that they felt anxious before the scan.

Figure 1.

(a) Percentage of participants who responded to each option of Likert Scale responses to Question 1 – ‘I generally feel anxious’. (b) Percentage of participants who responded to each option of Likert Scale responses to Question 2 – ‘I felt anxious before the scan’.

Likert questions 3–5 (‘I felt anxious during the scan’, ‘I felt anxious about the outcome’ and ‘I was anxious about the safety for my baby’) showed no statistically significant difference between the three groups ([χ²(2) = 2.4, P = 0.67], [Fisher's exact, P = 0.33] and [χ²(2) = 4.5, P = 0.34], respectively). Forty‐three percent (43%, n = 13) of participants in both Group B and Group C either agreed or strongly agreed with the statement ‘I felt anxious during the scan’ (Fig. 2a). In Group A, 37% (n = 11) of participants said that they agreed or strongly agreed with that statement (Fig. 2a). When proposed with the statement ‘I felt anxious about the outcome’, 73% (n = 22) of Group A, 63% (n = 19) of Group B and 73% (n = 22) of Group C stated they agreed or strongly agreed (Fig. 2b). Thirty‐three percent (33%, n = 10) of participants in Group A, 23% (n = 7) of participants in Group B and 33% (n = 10) of participants in Group C either agreed or strongly agreed to the statement ‘I was anxious about the safety for my baby’ (Fig. 2c).

Figure 2.

(a) Percentage of participants who responded to each option of Likert Scale responses to Question 3 – ‘I felt anxious during the scan’. (b) Percentage of participants who responded to each option of Likert Scale responses to Question 4 – ‘I felt anxious about the outcome’. (c) Percentage of participants who responded to each option of Likert Scale responses to Question 5 – ‘I was anxious about the safety for my baby’.

When asked about the information leaflet they received, 94% (n = 28) of participants in Group B and 97% (n = 29) of participants in Group C said that it was easy to understand (Table 2). One participant (3%, n = 1) in each group did not answer this question. Of the participants in Group B (who received the basic information leaflet), 87% (n = 26) said that it told them everything they wanted to know, with the remaining 13% (n = 4) stating they wanted to know more (Table 2). Ninety‐three percent (93%, n = 28) of participants in Group C said that the comprehensive information leaflet they received told them everything they wanted to know, with 7% (n = 2) answering they wanted to know more (Table 2). There was no statistically significant difference between groups in regards to this question (Fisher's exact, P = 0.67).

Table 2.

Participant responses to questions about foetal MRI information leaflets.

Question	Participant response	Group B – basic information leaflet	Group C – comprehensive information leaflet
		n (%)	n (%)
		n = 30	n = 30
(a) Was the information leaflet easy to understand?	Yes	28 (94%)	29 (97%)
	No	1 (3%)	0 (0%)
	Question not answered	1 (3%)	1 (3%)
(b) Did you receive enough information from the leaflet?	Yes, it told me everything I wanted to know	26 (87%)	28 (93%)
	No, I wanted to know more	4 (13%)	2 (7%)
	It gave too much information	0 (0%)	0 (0%)
(c) Did the information leaflet make you feel better or worse about the MRI?	It made me feel less anxious	18 (60%)	22 (73%)
	It made me feel more anxious	0 (0%)	0 (0%)
	It did not change my anxiety levels	12 (40%)	8 (27%)

In Group B, 60% (n = 18) of participants stated the information leaflet made them feel less anxious and 40% (n = 12) said that it did not change their anxiety levels (Table 2). In Group C, 73% (n = 22) of participants said that the information leaflet reduced their anxiety levels, and 27% (n = 8) said that it did not change their anxiety (Table 2). These results showed no statistically significant difference between groups (χ²(2) = 1.2, P = 0.27).

Thematic content analysis of the open‐ended questions resulted in four main themes: procedural information, timing of education, outcome/results and anxiety‐reduction methods (Table 3). Participants expressed anxiety towards the general process of the MRI, the outcome or results of the scan, and the safety of the modality. Participants wanted more information provided to them, and they would prefer it to be provided at the time of the referral.

Table 3.

Thematic content analysis.

Thematic code	Example
Procedural Information (subgroups: noise, temperature, breath holds and safety information)	‘Before my first foetal scan a week ago I would have liked to have known about loud noises and that I would have been asked to hold my breath many times’ – Group A participant (FtMRI07A) ‘Risks to baby, choice of when to do it (e.g. 32 weeks, 34 weeks, etc.), raised temperature, why it is necessary/what exactly are they looking for’ – Group A participant (FtMRI25A) ‘Photos/images to explain would be good’ – Group B participant (FtMRI02B) ‘What the MRI does/brief overview of how it works’ – Group C participant (FtMRI04C) ‘More reassurance on the safety of the MRI. Maybe some statistics?’ – Group C participant (FtMRI04C)
Timing of education	‘A run through of the process before walking in’ – Group A participant (FtMRI10A) ‘Knowing what to expect (fully) before showing up to the MRI ‐ receiving this information when the doctor told me I needed the MRI done’ – Group B participant (FtMRI03B) ‘A leaflet before having the scan (at least a few hours) instead of right before scan would have been useful’ – Group B participant (FtMRI09B) ‘If the flyer was given to me at time of booking. I'm nervous about needles and unsure on safety of contrast for baby. It would've helped having it prior’ – Group C participant (FtMRI21C)
Outcome/Results	‘My anxiety is about my baby's condition’– Group A participant (FtMRI21A) ‘The anxiety was more to do with results than the scan. The doctors and MRI team were great. The anxiety is more to do with my pregnancy than the scan’ – Group B participant (FtMRI33B) ‘I think the nature of having to have the scan because of abnormalities precludes reducing anxiety but the flyer was good’ – Group C participant (FtMRI28C)
Anxiety‐Reduction Methods (subgroups: support person, communication with radiographer)	‘Just having someone inside with me helped’– Group A participant (FtMRI13A) ‘Listening to music helped calm my anxiety and the radiographer I had was friendly and calming and happy to answer any questions I had' – Group B participant (FtMRI06B) ‘More talking through it’ – Group B participant (FtMRI14B) ‘The radio was good, music helps calm people, heads up about the loud noises from staff was good’– Group C participant (FtMRI18C)

Discussion

The aim of this study was to highlight areas within the MRI process which cause women to feel anxious and to determine whether educational leaflets left mothers feeling better informed about their foetal MRI and, therefore, less anxious.

Our results showed clear dissonance between the Likert scale questions (Figs. 1 and 2) and the yes/no questions in Table 2. Participants in Group A and Group B reported lower baseline or general anxiety compared to participants in Group C. Without receiving any foetal‐MRI specific information leaflet, Group A reported the least anxiety before and during the scan compared to Groups B and C. Based on previous literature, ⁴ , ²⁰ , ²¹ it was the authors' assumption and hypothesis that providing patients with a comprehensive foetal MRI‐specific information leaflet would help reduce maternal anxiety. However, anxiety can negatively influence a patient's concentration and understanding of new information. ³⁰ Therefore, it is plausible that having an information flyer to read before a scan could cause more confusion and increase anxiety. Solely reviewing the Likert data presented in this study, one could infer that the more information patients receive, the more they are aware to be concerned or anxious about. However, as presented in Table 2, the information leaflets used in this study did not increase anxiety in any participants in Groups B and C. Additionally, the Likert scale question ‘I felt anxious before the scan’ could have been interpreted differently by participants in Groups B and C – some may have answered this question referring to how they felt before reading the information leaflet, and some referring to after it was read. As mentioned later in study limitations, anxiety was evaluated retrospectively, and since emotions would be likely to change throughout the entire MRI process, it is reasonable that this may have influenced participant's answers. In line with previous literature indicating that being better informed leads to reduced anxiety, ⁴ , ²⁰ , ²¹ , ³¹ the authors attribute this lower reported anxiety in Group A to their lower baseline/general anxiety (in comparison to Groups B and C). In Group C, 73% (n = 22) of participants reported the comprehensive information leaflet made them feel less anxious. Whilst not statistically significant, a smaller percentage of participants in Group B (60%, n = 18) reported the basic information leaflet made them feel less anxious.

Ultrasound is well accepted by mothers and is mostly regarded as a positive experience – improving parental bonding, leading to more positive health behaviours and potentially decreasing anxiety. ¹⁹ , ³² , ³³ In a study by Garel, ² anxiety was reported as higher before MRI compared to US. ² Results of this study demonstrate that mother's recognise MRI as a secondary modality for a higher‐level diagnosis. In all groups, there were 31–44% additional participants who agreed/strongly agreed they were anxious before the MRI scan compared to those who answered they were generally anxious. Fifty percent or more of participants in all groups agreed or strongly agreed they were anxious before the scan. The majority of participants in all three groups (over 60%) were anxious about the results. These results indicate that having to undergo a foetal MRI induces anxiety in a great proportion of patients – particularly regarding the results. This is understandable given the secondary nature compared to US. Whilst this is something that educational leaflets cannot address directly, it is key for departments to understand in helping to reduce patient anxiety and improve the overall experience. Health practitioners should ensure they discuss the process and timeline for receiving results with patients to help alleviate anxieties.

In all groups, approximately one‐third (26–37%) of participants agreed or strongly agreed they were anxious about the safety for their baby. Finding that participants still reported anxiety regarding the safety after receiving information about this reinforces the need for clear, specific education and reassurance on this topic.

Some of the participants who did not feel any anxiety prior to the MRI, did not report a reduction in anxiety after receiving the information leaflet, which was to be expected. Of the 12 participants (40%, n = 12) in Group B who said that the basic information leaflet did not change their anxiety levels, seven of those (58%) said that they did not feel anxious to begin with. Eight participants (27%, n = 8) in Group C said that the comprehensive information leaflet did not change their anxiety levels; one of those participants (12.5%, n = 1) said that they did not feel anxious to begin with. There were eight participants in Group B and three participants in Group C who disagreed or strongly disagreed with the statement ‘I felt anxious before the scan’. Of these 11 participants who said that they were not anxious before the scan, four said that their respective flyers made them feel less anxious. This could be a result of human error if the participant read or interpreted the questions incorrectly. However, it could also mean that potentially these participants felt better or less anxious following the information leaflets, without knowing they may have felt anxious prior to the scan.

The results of the thematic content analysis supported the quantitative results and emphasised that women need more information about the MRI scan itself, the scan results interpreted, and implications of the outcomes. A recurring theme in the open‐ended questions was that some participants would have preferred to receive the information leaflet from their doctor at the time they were referred for the scan, not immediately before the scan. Education for referrers and ensuring information leaflets are available for them to provide to patients could be a vital component in helping to reduce maternal anxiety. Anxiety can influence patients' ability to comprehend and absorb information. ³⁰ Providing patients with education well in advance of the MRI scan is reasonable as it allows the opportunity to properly comprehend the information, and ensures patients have time to form any questions they may have for the referrer or radiographer. ²¹

Interestingly, many of the comments made by Group A participants regarding what they would have liked to know beforehand (e.g. temperature of the scan and breathing instructions) were addressed in the information leaflets for Groups B and C. Additionally, a Group B participant stated she would have benefited from photos of the MRI scanner (Table 3) which were supplied in the comprehensive information leaflet to Group C. In support of the quantitative data, patient statements such as these support the benefit detailed education can have on anxiety and the overall experience.

The results reported for the current study reflect those of previous publications of a similar nature ⁴ , ²⁰ , ²¹ , ³¹ ; patients experience fear and anxiety regarding MRI scans and the potential of a negative diagnosis. Similar to previous studies, this research found that patients benefit from pre‐scan education, and when delivered in the form of an information leaflet, it helps to reduce this anxiety. ⁴ , ²⁰ , ²¹ Future research examining the format and content of patient education would be beneficial – for example, whether a leaflet and follow up phone call to discuss the information would result in a greater reduction in anxiety than the leaflet alone. In the interim, there perhaps needs to be greater collaboration between departments and referring doctors to help improve the referrers’ education on the foetal MRI imaging process. This would ensure that referrers have accurate information to provide to patients at the time of referral, reducing overall anxiety and improving the patient experience.

This study has several limitations. Firstly, there is the potential of sampling bias, given this study was conducted in a medical imaging department at a single hospital. The generalisability of these results to other departments may therefore be limited. Underlying mental health conditions were not determined and this could have influenced the levels of anxiety participants expressed. Another limitation of this study was that anxiety was evaluated retrospectively once the MRI scan was complete. Depending on the participant's expectations, their attitude and anxiety towards the MRI scan could have changed throughout the MRI experience, potentially affecting their answers. We could not control the level of information participants received from their referring doctors which could also have influenced their anxiety levels regarding the MRI. It was evident through open‐ended questions that some participants had taken anxiety‐reducing medications before the MRI scan. This was something participants were not questioned about but could have influenced the anxiety they felt towards the MRI scan, and therefore, the results. This study investigated the influence of paper‐based information leaflets only on patient education. Other methods of delivering information about foetal MRI to patients may have varying impact on maternal anxiety. Finally, the conversion of data from paper copies to digital data was performed by the primary author only, therefore errors in the raw data are possible.

Conclusion

Whilst not all patients expressed anxiety regarding the MRI scan itself, emotional distress surrounding the entire process was evident and majority of patients experienced anxiety. Key areas participants expressed anxiety towards were the general process of the MRI, the outcome/results of the scan and the safety of the MRI. Participants in this study highlighted the need for this information and the importance of when it is received. The majority of participants in this study reported that a foetal‐MRI specific information leaflet made them feel less anxious. Although there was no statistically significant difference between the basic and comprehensive information leaflets with regards to reducing anxiety, the comprehensive version was not inferior. As per the qualitative data presented in this study, the authors recommend providing patients with a detailed, foetal‐MRI specific information leaflet. This resource should include details about the entire MRI process, imagery of the MRI machine and positioning, timing of results and methods to help reduce anxiety. Results from this study also suggest that information leaflets should not be solely relied upon as a method to reduce anxiety. Participants in this cohort expressed the need for information as early as possible. Future research into the timing of education and alternate methods of delivery (e.g. consultation with a doctor or MRI team member) would be beneficial to reducing maternal anxiety and improving the overall experience.

Funding

This research project received no funding.

Conflict of Interest

The authors declare no conflict of interest.

Supporting information

Appendix S1. Patient information leaflet (basic).

Appendix S2. Patient information leaflet (comprehensive).

Data Availability Statement

Author elects to not share data.