Seizing the 9-month moment: addressing behavioral risks in prenatal patients

Patient Educ Couns. 2006 May;61(2):228-35. doi: 10.1016/j.pec.2005.04.001. Epub 2005 Oct 26.


Objective: Our qualitative study explored prenatal care providers' methods for identifying and counseling pregnant women to reduce or stop smoking, alcohol use, illicit drug use, and the risk of domestic violence.

Methods: We conducted six focus groups (five with OB/Gyn physicians, one with nurse practitioners and certified nurse midwives), total N=49, using open-ended questions. Investigators analyzed transcripts to identify and describe themes.

Results: Three major themes emerged: (1) specific risk-prevention tactics or strategies exist that are useful during pregnancy; (2) some providers address patients' isolation or depression; and (3) providers can adopt a policy of "just chipping away" at risks. Specific tactics included normalizing risk prevention, using specific assessment techniques and counseling strategies, employing a patient-centered style of smoking reduction, and involving the family.

Conclusions: Providers generally agreed that addressing behavioral risks in pregnant patients is challenging. Patient-centered techniques and awareness of patients' social contexts help patients disclose and discuss risks.

Practice implications: Brief but routine assessment and risk reduction messages require little time of the provider, but can make a big difference to the patient, who may make changes later.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Attitude of Health Personnel*
  • Counseling / methods*
  • Female
  • Focus Groups
  • Health Behavior*
  • Humans
  • Nurse Midwives / psychology
  • Nurse Practitioners / psychology
  • Nursing Assessment / methods
  • Nursing Methodology Research
  • Obstetrics / methods
  • Patient Education as Topic / methods
  • Patient-Centered Care / methods
  • Pregnancy
  • Pregnancy Complications / prevention & control*
  • Prenatal Care / methods*
  • Qualitative Research
  • Risk Assessment / methods*
  • Risk Reduction Behavior
  • San Francisco
  • Smoking Prevention
  • Spouse Abuse / prevention & control
  • Substance-Related Disorders / prevention & control
  • Surveys and Questionnaires