Date of Award


Document Type


Degree Name

Doctor of Education (EdD)


Executive Leadership

First Supervisor

Dianne Cooney Miner


Pregnancy, with the inherent need for prenatal care, is a global condition. Research has demonstrated a positive relationship between maternal adherence to prenatal care with associated maternal, fetal, and delivery outcomes of pregnancy. Non-adherence has been shown to increase risks of maternal and fetal morbidity and mortality. Despite the importance of care, maternal adherence to prenatal care is problematic, pervasive, and persists without an identified etiology. Research to identify a causation for maternal nonadherence has focused upon groups of women with shared traits or circumstance as a predisposing risk. The aim of this study was to identify how adherent multiparous patients perceive the significance or value of prenatal care. A qualitative semi-structured research study, utilizing a directed content approach with the health belief model as a theoretical base, indicated five themes with an overarching theme of Maternal Fetal (M-F) attachment as motivating cues to action in seeking care. The maternal patients in this study were all found to have established M-F attachment, prompting them to seek care. Understanding the importance of M-F attachment, and the way in which individual maternal needs may be met throughout pregnancy, has the potential for improved practice aimed at increasing adherence rates. Further research is indicated to explore the multifactorial origins of established M-F attachment, and ways to deliver patient centered-care in practice to meet the diverse and changing needs of maternal patients. The ultimate goal for practice is to improve maternal adherence rates, subsequently affecting improved maternal, fetal, and delivery outcomes.

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