Exploring healthcare providers’ perceptions of normative care needs among women with multiple sclerosis during pregnancy and the first year postpartum: a qualitative study

Pregnancy rates among women with multiple sclerosis (MS) are lower than in the general population, and those who become mothers face complex and multifaceted caregiving challenges. While previous studies have explored the experiences and perceived needs of women with MS during their reproductive years, the normative needs, as perceived and prioritized by healthcare providers (HCPs), have not been examined. This study explored HCPs’ perceptions of normative care needs among women with MS during Pregnancy and the First Year Postpartum. This qualitative study utilized the conventional content analysis method and was conducted from June 2023 to the end of March 2024 in Mashhad, Iran. Sixteen HCPs from diverse disciplines, including neurology, obstetrics and gynecology, midwifery, nursing, and mental health, were purposefully selected with maximum variation. Sampling began with face-to-face semi structured interviews at participants’ workplaces (personal offices, hospitals, and health centers) and continued until data saturation was reached. Data analysis was performed using Graneheim and Lundman’s method and MaxQDA version 10 software. The analysis generated three main categories and nine subcategories: 1- Defining Essential Informational Care with 2 subcategories including Clinical information related to fertility and disease, Information provision for family members regarding the mother’s needs, 2- Establishing Professional Counseling Care with 4 subcategories including Addressing sexual health concerns, Guiding family planning decisions, Addressing psychological concerns, Advising on pharmacological management, and 3- Framing Individualized Clinical Care with 3 subcategories including Developing MS-specific clinical guidelines, Tailoring clinical care to individual needs, Optimizing access to clinical services through remote modalities. The findings highlight how HCPs identify and interpret the care needs of women with MS during pregnancy and the postpartum period. From the perspective of HCPs, the provision of structured information, expert advice, and coordinated care approaches are identified as key components of women’s care during this period. By clarifying these normative needs, the study findings can contribute to a clearer understanding of the gap between women’s desired needs and routinely provided care, and can offer a framework for standardized care that more closely aligns with patients’ needs.