| Description |
The purpose of this study was to generate a grounded theory explaining the decision making processes used by childbearing women to choose a primary health care provider. One of the maternal tasks of pregnancy is to seek safe passage for the mothers and their unborn children. Health care providers play an important role in the childbearing experience by sharing information, giving support, providing access to resources, and providing care during childbirth. Linkages have been demonstrated between the use of health care services during pregnancy and subsequent interactions with the health care delivery system. There is a paucity of literature on the processes childbearing women as consumers of health care go through in choosing a caregiver. In this study, 30 women were interviewed during pregnancy and following childbirth about their choice of health care providers. These interviews captured the decision making process. Demographic data were analyzed using descriptive statistics. Qualitative data analysis was done using constant comparative analysis. Comparisons were made within and across interviews in a concurrent process of data collection and analysis. Trustworthiness of the data was established. The decision making process was framed by access issues, including financial constraints such as health insurance coverage and nonfinancial constraints such as the availability of caregiver specialty, availability of a certain caregiver, and the desire for a caregiver of a specific gender. The basic social process identified was finding a fit with the choice of a health care provider, which has cognitive and affective components and may be an active or passive process. Processes contributing to finding a fit included (1) making the choice by consulting other women and verifying the choice; (2) confirming the choice by checking out the caregiver, then feeling comfortable or making a change; and (3) reconciling expectations with reality following childbirth as the women evaluated their experience with their caregiver. Women felt satisfied or resolved to make a change. Gaining insight into the processes used by women to choose a health care provider makes an important contribution to the body of knowledge of women's health, with the potential to improve the quality of life for women and their families. |
