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Survey study reveals strong clinician support for expanded prenatal follow-up in obstetric care, highlighting social risks as primary drivers of pregnancy complications.
BACKGROUND: Since 1992, a decline in the birth rate has been registered in Russia. Negative natural population growth has been accompanied by a deterioration in women’s reproductive health and a high incidence of complicated pregnancies and childbirths. Providing follow-up care for women of reproductive age is considered a priority for preventing complicated pregnancies and childbirths. AIM: The study aimed to analyze and compare the opinions of obstetricians and gynecologists on the risks of complicated pregnancies and the importance of follow-up care for pregnant women. MATERIALS AND METHODS: The sociological study “The Role of Follow-Up in the Healthcare of Pregnant Women” involved 157 obstetricians and gynecologists from women’s clinics in the Saratov region. The majority (97%) of respondents were women. Almost half of the respondents (44%) had more than 30 years of work experience. A structured questionnaire developed by O.P. Shchepin et al. was used for data collection. RESULTS: A recent analysis of the opinions of obstetricians and gynecologists in the Saratov region revealed that the majority (60%) of respondents strongly believed in the importance of enhancing follow-up care in protecting women’s health during preconception preparation, pregnancy, and postpartum management. Meanwhile, 46% of respondents highlighted the importance of follow-up care specifically during pregnancy. According to the respondents, 78% of pregnant women are registered for follow-up early (within the first 12 weeks of pregnancy). Additionally, 88% of respondents attributed late registration to a lack of personal responsibility for health — both for the woman and the unborn child. To facilitate timely registration, 62% of respondents engage in individualized work with women of reproductive age. The possibility of consulting a pregnant woman about the detected diseases in the conditions of public healthсare was mentioned by 70% of the respondents. While 70% of respondents reported observing normal labor courses in their practice, 30% indicated that complicated deliveries occur more frequently. In the context of social care for pregnant women, 62% of respondents issue certificates of transfer to lighter work duties. Responses varied widely regarding the possible causes of endangering the health of a woman and her child. According to 62% of respondents, improving the follow-up care for pregnant women will definitely have an impact on reducing maternal mortality. A comparative analysis revealed that the obstetricians and gynecologists participating in these surveys identified social risks as the primary threats to maternal and child health. CONCLUSION: The study confirms the social determinacy of complicated pregnancies, which indicates the need to overcome the medicalization of follow-up care for pregnant women.
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Rebrova et al. (2025) studied this question.
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