Barriers and facilitators for optimal perinatal primary care in low-risk pregnancies: an interview study with parents and healthcare professionals

BACKGROUND: Shortened postpartum hospital stays have shifted perinatal care to primary care settings, potentially expanding the role of primary care midwives. However, specialist care remains prevalent during perinatal stages and the role of midwives in primary care is undefined. We aim to investigate current barriers to optimal organization of perinatal care at the primary care level for low-risk pregnancies in Flanders, Belgium, focusing on organization, accessibility, and quality of care. In addition, we explore what inhibits or can facilitate the expansion of the role of primary care midwives herein. METHODS: We conducted interviews with thirteen parents and nineteen healthcare providers. Parents had experienced parenthood within the past year, and healthcare providers had at least one year of experience in primary care. Participants were recruited through professional associations and regional primary care zones in the city of Antwerp. We applied a qualitative inductive content analysis. RESULTS: Seven barriers emerged, highlighting areas for improvement in perinatal primary care and the potential role of midwives. Findings underscore the need for increased awareness of preconception care, enhanced psychosocial follow-up, streamlined role distribution among healthcare providers, integrated offer of prenatal care, clarity about the value of postpartum care early on, and improved access to medical records. CONCLUSIONS: The study identifies key opportunities for optimizing perinatal primary care. Coordinated care pathways, clear role distribution, and a unified patient record offer opportunities to enhance interprofessional collaboration in primary care. Continued dialogue and further research are recommended to develop an effective perinatal primary care model.