Mothers’ experiences of team-based antenatal care in rural British Columbia

Introduction: The health care system in British Columbia places priority on providing teambased primary maternity care. Participation of mothers in planning their care is an essential component of team-based care. Therefore, it is important to understand mothers’ experiences of team-based maternity care. Background: An integrated literature review resulted in 12 articles focused on mothers’ experiences with antenatal care delivered by a team of providers. Evidence highlighted the positive impact of team-based speciality antenatal care. Mother’s experiences of community team-based antenatal care were a notable gap in the literature. Objective: To explore antenatal care experiences of mothers living in rural British Columbia, where team-based antenatal care is known to exist. Method: To understand the perceptions of mothers' experiences of team-based antenatal care a qualitative methodology was used. An interpretive description approach combined semi-structured interviews with eight mothers purposively selected from two rural communities. Findings: Mothers played a key role in shaping the continuity of their care. Mothers collaborated with their providers across three types of continuity expressed within a team-based antenatal care context: management, informational, and relational. Building the relationship between the mother and a consistent provider (relational continuity) required clinical coordination (management continuity) and clear communication (informational continuity). From the mother's perspective, a specific team composition did not rate as highly as the connection to a consistent provider with whom they had respectful and trusting relationship. For all eight mothers a nurse and physician team-combination promoted continuity and patient-centeredness. Specifically, a primary care maternity nurse role supported stability in the mother's antenatal care. Gaps in continuity arose from experiences of antenatal care during the Covid-19 global pandemic and in the mothers’ mental wellness and pelvic floor health. Conclusion: When the mothers shared responsibility for continuity in care this strengthened the mother-provider partnership, regardless of which discipline was providing care. Mothers appreciated the continuity of carer – a provider who could develop a relationship with them during their antenatal care. The mothers valued providers who worked as part of a network, collaborating with a range of interdisciplinary providers to support the mothers’ antenatal care needs. Clinical Implications: There is merit in expanding discussions on the value a consistent provider working alongside mothers in rural team-based primary maternity care brings to mothers’ experiences of and engagement with antenatal care. Future research on how both continuity of care and continuity of a carer can support sustainable team-based antenatal care to improve outcomes is warranted in all community contexts.