Beyond Common Outcomes: Clients' Perspectives on the Benefits of Prenatal Care Coordination

Prenatal Care Coordination (PNCC) is a fee-for-service Medicaid benefit available in Wisconsin and several other states. It provides for home visiting, health education, care coordination and other supportive services to high-risk mothers. However, PNCC is not supported by an evidence-based model, its impact is not systematically evaluated, and the benefit is not currently reaching all eligible mothers. The purpose of this qualitative descriptive study was to describe PNCC clients' perspectives on the experience of receiving the benefit and the value and impact of PNCC in the context of their own lives. We interviewed recent clients of PNCC programs in two PNCC sites that varied by racial/ethnic community makeup, rural/urban geography, and health department size. PNCC clients identified two major benefits of PNCC: 1) social and emotional support from the PNCC nurse; and 2) assistance with obtaining or getting connected to other resources they needed. These two program benefits were especially meaningful to PNCC clients in the context of difficult life events and circumstances. Findings from this study highlight the impact of PNCC services on social and emotional health through trusting and supportive nurse-client relationships. Our findings also suggest that a longer program period and the development of standards to assess program effectiveness would improve PNCC client outcomes and reduce disparities in maternal health.