Table 3.
Thematic tree and excerpts from participant responses
| Domains | Themes | Codes | Excerpts | Frequency |
|---|---|---|---|---|
| Preferences regarding prenatal care and providers | Agency and choice | Giving choices/options | “I want a provider who gives options, discusses pro and cons, and listens to me and my concerns. I learned from my sister about options and didn't realize I could say no before. That I don’t have to be induced, or I can say no to a membrane sweep.” (P18) | 20 |
| Power/Agency/Control | “Previous male doctor; ‘I'm the doctor and you need to listen to me’; did not go over very well and cut that relationship off and switched providers never looking back.” (P8) | 14 | ||
| Flexibility in scheduling |
“Flexibility about my time and what works for me.” (P5) “The time of day I can make appointments and the location.” (P9) |
4 | ||
| Emphasis on maternal and child health and wellbeing | Addressing mental health | “They just do a basic check-up. If they checked on my mental health that would help. For example, ask questions about how I have been sleeping, coping with things or stress?” (P2) | 3 | |
| Genuine interest | “..my prenatal appointments are just hi, lets listen to baby's heart.” (P3) “…to feel like a priority…” (P22) | 15 | ||
| Time |
“…To not feel rushed and to feel like a priority…” (P22) “…I do not want a rushed labor I also want my voice to be heard…” (P6) |
3 | ||
| Baby check-ups | “I like the fact that they always check about my baby.” (P5) | 6 | ||
| Familiar and Experienced | Familiar/Continuity of care | “knows my husband's name, asks me about my symptoms, makes sure my bloodwork is done; on track with my blood pressure due to my preeclampsia history” (P11) | 8 | |
| Rapport | “A familiar provider that we already have a bond.” (P19) | 4 | ||
| Professional experience | “…in addition to their training. Number of years of experience in training was also very important to me…” (P6) | 4 | ||
| Personally Engaging | Encourages questions | “She encourages me to think of questions that I will like to ask and bring them to the appointments.” (P25) | 3 | |
| Collaborative |
“ I don’t want a provider that is pushy and rigid”. (P18) “…asks me my goals for the day…” (P27) |
6 | ||
| Good listener | “Listening to what I'm saying and my opinion and not be dismissed.” (P10) | 5 | ||
| Emotionally safe and supportive | Supportive | “I want someone who wants to give me a natural vaginal delivery and knows how to support me through it, because that is what I want” (P6) | 3 | |
| Comforting | “Assurance that everything will be okay, especially if I’m not doing well right now, to assure me that it's not last hope and that everything will be okay” (P25) | 9 | ||
| Non-judgmental | “I had the experience with my first baby where the provider said, ‘You should be used to this by now’… regarding a cervical exam. I was surprised she said this and still remember it to this day. She shouldn't have said that.” (P1) | 11 | ||
| Respectful | “…respecting my body and the things that are happening with my body…respecting how I feel about certain things and my body…” (P14) | 3 | ||
| Validating | “…Validating, not dismissing…” (P14) | 4 | ||
| Provision of information and resources | Providing explanations | “I appreciate being informed about everything is happening. Explain why she is doing what she is doing and how it correlates to the pregnancy.” (P14) | 10 | |
| Universal access to information and resources | “I would like to receive general information and then I can pick and choose what I need. Once my specific needs are identified then the provider can provide more directed care”. (P26) | 33 | ||
| Nutritional support | “WIC, not sure if I make too much to qualify?”. (P27) | 5 | ||
| Basic needs | “Help with different coupons. Show me where to go to buy coupons for diapers and food and other baby supplies.” (P20) | 9 | ||
| Transportation support | “transportation and financial issues are sometimes an issue”. (P8) | 2 | ||
| Perinatal classes | “Prenatal classes (including those outside of UI health with more flexible hours), mental health resources, access to webinars for moms who cannot make it to prenatal classes”. (P9) | 10 | ||
| Maternal and child health services | “…help finding resources like doulas, midwives…” (P3) | 13 | ||
| Mental health support | “Classes like this for reducing stress in pregnancy. If I am a stressed out working mom, who happens to be in the counseling field, I am sure there are others out there who are also stressed out and in need of skills” (P9) | 9 | ||
| Concordant care | Racial identification | “Having a black midwife was very important to me.” (P6) | 1 | |
| Lived experience with pregnancy and childbirth | “I wanted someone who had kids. I believe that them having their own experience helps to provide more insight”. (P6) | 1 | ||
| Preferences in addressing trauma | Variable value of addressing trauma | Demonstrates caring | “I feel they should ask in the beginning because it does relate to my mental health”. (P2) | 3 |
| Tailoring care | “Understanding the way they grow up will help you to match the appropriate care”. (P14) | 7 | ||
| Intergenerational trauma | “When you are discussing care and discussion of a child in general will help you approach certain situations”. (P14) | 2 | ||
| Mistrust | “I can't assess how genuine they are so I would like them so I don't want them to ask”. (P12) | 4 | ||
| Variable approaches to asking about trauma | Verbal discussion | “I prefer to talk more personally to another person and for them to gather a full understanding. I prefer to talk it out more”. (P8) | 12 | |
| Questionnaire | “The questionnaire may be better rather than the flow of conversation where they may feel less comfortable to be less open and honest”. (P14) | 12 | ||
| Universal approach | “Targeting will limit who is helped”. (P14) | 8 | ||
| Sensitive and empathetic inquiry and response | Asking sensitively | “Start with a question. Felt safe at home. Felt that it was an important question”. (P18) | 2 | |
| Explain importance | “Preface it with I am going to ask and there are studies that show why it is important; afterwards what did your experiences teach you and do you want to do anything differently? Explain how it relates to them today”. (P19) | 2 | ||
| Respond Sensitively/without judgement | “be open minded about what you say, and be mindful about what you say in response”. (P24) | 4 | ||
| Respond with empathy not sympathy |
“Caring and helpful and showing they are there to care for me and be an advocate for me”. (P9) “No particular way. I like things to be natural. You have experience and expertise that I don’t have. If there is anything you have to say that could benefit myself and my child, then say it.” (P19) |
4 |