Lived experience of hypertensive disorders of pregnancy: Identifying barriers and improving care-A systematic review and meta-analysis.

Abstract

Background: Affecting ~10%-15% of pregnancies worldwide, hypertensive disorders of pregnancy can cause maternal and neonatal morbidity and mortality.

Objective: To understand the patient experience of being treated for hypertensive disorders of pregnancy.

Search strategy: Between database inception and June 2024, Medline via Ovid, Embase via Ovid, CINAHL via Ebsco, PsycINFO via Ebsco, Scopus, Web of Science Core Collection, and ASSIA via ProQuest were searched.

Selection criteria: Studies were included if they contained qualitative data about the lived experience of hypertensive disorders of pregnancy. Critical Appraisal Skills Program checklist for qualitative research was used to perform a quality assessment.

Data collection and analysis: NVivo was used to label and organize a framework of themes and subthemes.

Main results: The meta-synthesis included 18 studies. Central themes emerged related to structural and individual barriers to accessing care, understanding of condition and care offered, interactions with providers and the experience of receiving treatment. The subtheme of baseline knowledge/understanding and being informed was mentioned most frequently and consistently across studies (frequency effect size 94.4% and intensity effect size 29.1%). Many women reported the need for greater awareness and education regarding blood pressure in pregnancy and the need to seek prenatal care early.

Conclusions: We identified areas where woman-centered care for hypertensive disorders of pregnancy could be improved, using reports from across different global contexts. Based on this data from the patient experience, interventions that focus on health education and patient empowerment would improve the quality of the experience of receiving care during pregnancies complicated by hypertensive disorders.