Enhancing person-centered obstetric care: A qualitative grounded theory study on perception formation and sense-making during childbirth

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INTRODUCTION: Quality of obstetric care comprises both provision and experience of care, yet patient experiences have received less attention. Person-centered care seeks to tackle this gap by attributing equal significance to clinical outcomes and care experiences. Individual experiences vary despite similar treatments because subjective appraisals differ. Understanding this process can help to enhance person-centered care in obstetrics. The study's aim is to explore how birthing persons perceive and make sense of obstetric care experiences. METHODS: The qualitative study adopted a grounded theory approach according to Corbin and Strauss, utilizing 12 narrative interviews with mothers who gave birth in a hospital a maximum 12 months prior. They were recruited through iterative theoretical sampling through the project Instagram channel between March and August 2023. The iterative process of data collection, analysis and constant comparison resulted in a theoretical model explaining how parturients experience obstetric situations. RESULTS: During analysis, sense of coherence (SoC) emerged as core category shaping how parturients perceive and make sense of obstetric situations: negative experiences related to low manifestations of SoC and positive experiences to high SoC. A subsequent literature review linked these empirical findings to Antonovsky's SoC which was contextually adapted to the perception of obstetric situations shaped by comprehensibility, perceived manageability and contextual framing factors. CONCLUSIONS: Recognizing how parturients construct meaning through their situational SoC, may offer a basis for reflections on interaction with them. Though not allowing for direct generalization, the findings may offer a theoretical concept for further research targeting situational SoC during care processes or piloting feasible measures for real-time assessment.

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