Trusting parent-profesional relations within a cross-sectoral intervention for expectant and new parents in vulnerable positions

Background: Social inequalities inflicting on expectant parents can affect a child’s course for health and wellbeing already during pregnancy. These effects may be mitigated through early, prenatal intervention. Accordingly, a cross-sectoral intervention was commenced in the North Denmark Region in 2017, in which expectant parents identified with psychosocial vulnerabilities receive team meeting(s) with a midwife and a health visitor for planning targeted support. However, vulnerable parents may be concerned of service engagement. This may be overcome through trusting parent-professional relations, although further knowledge hereof is needed within interprofessional maternity care services. The aim of this study was therefore gaining deeper understanding of how and under what circumstances trusting parent-professional relations develop and work in cross-sectoral intervention delivery of maternity care services. Method and
Material: This study forms part of a realist evaluation. It encompassed 14 interviews with midwives and health visitors and 11 observations of team meetings across four municipalities.
Findings: Multiple interconnected configurations of conditions and mechanisms facilitating and characterising trusting parent-professional relations were found, including woman/family-centredness; timeliness and relevance of interprofessional inclusion, and gentle bridging hereof; transparent communication; and relational continuity. A trustful interprofessional safety net was then established, which parents dared engaging with. Furthermore, good relations promoted trust in other professionals, whilst distrust hampered this.
Conclusion: Preliminary findings indicate that trusting relations between expectant parents in vulnerable positions and interprofessional care teams can be developed and maintained through continuously supportive approaches alongside transparently introducing the right professionals at the right time. This can promote engagement with maternity care services and achievement of parenting skills and coping abilities for mitigating effects of social inequalities.