The value of a learner's stance: lessons learned from pregnant and parenting women.

OBJECTIVES: The voices, perspectives, and experiences of pregnant and parenting women are vital sources of information often overlooked or not understood by professionals. The goals of this qualitative study were to understand access to maternal and child health services from the perspectives of diverse consumers, and provide rich descriptions to inform strategies to enhance the quality of this access. It explored key dimensions influencing their experiences, including health status and needs, significant others, cultural beliefs, and provider and organizational factors.
METHODS: The authors conducted 24 focus groups with 143 urban women, ages 14-45 who were primarily Medicaid consumers. Maternal and child health organizations providing primary or secondary services recruited African American, Caucasian, and Latina pregnant and parenting women.
RESULTS: Five themes on access and quality of participants' maternal and child health experiences emerged: the primary role that personable and caring health providers and staff played in accessing services; provider recommendations were oftentimes discounted as irrelevant; alternative health practices were motivated by a genuine desire to help themselves or their children; agency practices and policies were sometimes perceived as potentially discriminatory; and unresolved feelings regarding pregnancy.
CONCLUSIONS: These findings can assist providers to develop genuine relationships and address the unique cultural needs of their patients. Recommended actions include assuming a learner's stance as a way of developing an increased understanding of patients' underlying motives, perceptions of alternative health practices of their patients, and identifying the role and impact of their patient's social network.