Women’s experiences of group antenatal care: findings from a systematic review and feminist qualitative meta-synthesis

Abstract Background Group antenatal care offers social and relational elements of care that are often desired but rarely provided in maternity care services. Key components of the model involve: social support, continuity, inclusion of health assessments, and interactive learning, with the aim of providing a more holistic form of care, improving engagement and satisfaction. The objectives of this review were to: 1. identify and synthesise women's experiences of group antenatal care and 2. gather insights into underpinning elements of how the model works for pregnant women. Methods We searched articles from the databases CINAHL Complete, MEDLINE, Embase, MIDIRS, APA PsycArticles and Info, AMED, Emcare, Academic Search Complete, and SocINDEX, assessed the articles’ quality and analysed the women’s experiences thematically. For data synthesis, we drew on an intersectional feminist lens to better understand how group care is experienced, particularly by groups vulnerable to poorer maternal-infant health outcomes. Results In total, 21 articles were included with one article providing a theoretical underpinning of the model as ‘social medicine’. Most studies were conducted in higher income countries ( n = 18) and fewer in lower income countries ( n = 3). Study populations tended to consist of groups identified as at-risk for adverse maternal-infant health outcomes. A summary of pregnant women’s experiences reveals that many have positive experiences of the care model. Three overarching themes were identified as key underpinnings of how the model works for women: Learning through Sharing, Relationships and Model Design. Conclusions The way in which women learn and build relationships with each other, and their care providers are enhanced by the model’s design which emphasises facilitated discussion and varied teaching methods – all of which are closely aligned to a critical pedagogical approach. Future research is needed to better understand the model’s impact on women’s wider care needs, including addressing social and racial inequalities within maternal health. Systematic review registration The protocol for this review was registered on PROSPERO (Ref: CRD42021248227).