JMIR Publications

ABSTRACT

Background:

Background:

During pregnancy, self-rated health (SRH) and self-rated mental health (SRMH) are key indicators of health status and predictors of future healthcare needs. Various factors, including maternal childhood, socioeconomic status, and parity, may influence health during pregnancy. How pregnant women seek antenatal care from midwives and general practitioners (GPs) based on their health perceptions remains unclear. Understanding these health factors can help healthcare providers become more aware of the diverse needs of pregnant women.

Objective:

Objective:

This study aims to assess how SRH and SRMH during pregnancy are associated with maternal childhood experiences, socioeconomic status, parity, and antenatal care provided by midwives or general practitioners (GPs).

Methods:

Methods:

An anonymous, web-based cross-sectional survey was conducted from January to March 2022 among pregnant women in Norway, distributed via Facebook and Instagram. The survey included questions on SRH, SRMH, socioeconomic status, childhood perceptions, and antenatal program participation. Pearson’s chi-squared test and logistic regression models were used to explore associations and estimate odds ratios for good SRH and SRMH.

Results:

Results:

Among 1,402 participants, 94.7% reported good or very good health before pregnancy, dropping to 67.8% during pregnancy (p<0.001). Reporting your childhood as good was associated with better SRH compared to those who reported average or difficult childhood (70.2% vs 64.0% vs 53.2%, p<0.001). This corresponds to 48% lower risk of good SRH if reporting a poor childhood than a good childhood (OR 0.52, 95% CI 0.36-0.76). Financial security and higher education were associated with better SRH (both p<0.001). First-time mothers reported better SRH than those with previous births (73.9% vs 61.4%, p<0.001). For SRMH, 89.9% reported good or very good SRMH before pregnancy, decreasing to 73.1% during pregnancy (p<0.001). Women who reported a good childhood, financial security, higher education, and first-time mothers reported better SRMH during pregnancy (p<0.001 for all). Nearly all women participated in the antenatal program, regardless of their subjective health, and most expressed satisfaction. Among participants, 53.7% received shared antenatal visits from midwives and GPs, 37.1% were seen only by midwives, and 5.8% only by GPs. The proportion of women receiving antenatal care solely from a midwife decreased with declining SRH, from 42.6% among those with very good SRH to 27.3% among those with poor SRH. Similarly, the proportion dropped from very good SRMH (39%) to poor SRMH (24.3%).

Conclusions:

Conclusions:

A difficult maternal childhood, poor socioeconomic status, and having given birth before were associated with poorer health during pregnancy. Both midwives and GPs played vital roles in providing antenatal care, though few women received care exclusively from GPs. The likelihood of physician involvement in care increased slightly with worsening health. Clinical Trial: Not applicable