Skip to main content

Perceptions of Health Care, Information, and Social Support Among Women Affected by Zika Virus Infection During Pregnancy in Two U.S. States

Abstract

Objectives

To understand the information needs and experiences with health care and social support among women with confirmed or possible Zika virus infection during pregnancy.

Methods

We conducted in-depth interviews with 18 women whose pregnancies were part of surveillance efforts in two states, Pennsylvania and Virginia. Using a semi-structured guide available in English and Spanish, we asked women about their experiences. We conducted a thematic analysis using NVivo 11.

Results

Only one participant reported that her infant had been diagnosed with health problems related to congenital Zika virus infection. Most participants said they received the information they needed about Zika virus and their infant’s medical care. Most participants primarily spoke Spanish and described satisfactory experiences communicating with providers, either using a mix of Spanish and English or using an interpreter. Coordination of care and clear communication among different providers was a key factor in participants’ satisfaction with health care received. Participants noted high levels of stress around the uncertainty associated with Zika virus exposure during pregnancy.

Conclusions for Practice

Although participants reported satisfaction with care, they also reported high levels of anxiety and challenges coping with the uncertainties along their journeys. Study findings support the need for guidance for providers about how to talk with women about Zika virus infection during pregnancy and specifically how to discuss the uncertainties about diagnosis and outcomes.

This is a preview of subscription content, access via your institution.

References

  1. Centers for Disease Control and Prevention (CDC). (2018). Vital Signs. Zika in babies in U.S. territories. Monitoring early health and development. Atlanta, GA: Centers for Disease Control and Prevention. Retrieved October 14, 2021 from https://www.cdc.gov/vitalsigns/zika-territories/index.html

  2. Delaney, A., Mai, C., Smoots, A., Cragan, J., Ellington, S., Langlois, P.,… Honein, M. A. (2018). Population-based surveillance of birth defects potentially related to Zika virus infection—15 States and U.S. Territories, 2016. MMWR Morbidity and Mortality Weekly Report, 67(3), 91–96. https://doi.org/10.15585/mmwr.mm6703a2

  3. Hall, V., Walker, W. L., Lindsey, N. P., Lehman, J. A., Kolsin, J., Landry, K.,… Martin, S. W. (2018). Update: Noncongenital Zika virus disease cases—50 U.S. States and the District of Columbia, 2016. MMWR Morbidity and Mortality Weekly Report, 67(9), 265–269. https://doi.org/10.15585/mmwr.mm6709a1External

  4. Honein, M. A., Dawson, A. L., Petersen, E. E., Jones, A. M., Lee, E. H., Yazdy, M. M.,… U. S. Zika Pregnancy Registry Collaboration. (2017). Birth defects among fetuses and infants of U.S. women with evidence of possible Zika virus infection during pregnancy. JAMA, 317(1), 59–68. https://doi.org/10.1001/jama.2016.19006

  5. McGovern, R., & Harmon, D. (2017). Patient response to physician expressions of uncertainty: A systematic review. Irish Journal of Medical Science, 186(4), 1061–1065. https://doi.org/10.1007/s11845-017-1592-1

    CAS  Article  PubMed  Google Scholar 

  6. Reynolds, M. R., Jones, A. M., Petersen, E. E., Lee, E. H., Rice, M. E., Bingham, A.,… U. S. Zika Pregnancy Registry Collaboration. (2017). Vital Signs. Update on Zika virus-associated birth defects and evaluation of all U.S. infants with congenital Zika virus exposure—U.S. Zika Pregnancy Registry, 2016. MMWR Morbidity and Mortality Weekly Report, 66(13), 366–373. https://doi.org/10.15585/mmwr.mm6613e1

  7. Rice, M. E., Galang, R. R., Roth, N. M., Ellington, S. R., Moore, C. A., Valencia-Prado, M.,… Honein, M. A. (2018). Vital Signs. Zika-associated birth defects and neurodevelopmental abnormalities possibly associated with congenital Zika virus infection—U.S. territories and freely associated states, 2018. MMWR Morbidity and Mortality Weekly Report, 67(31), 858–867. https://doi.org/10.15585/mmwr.mm6731e1

  8. Satterfield-Nash, A., Kotzky, K., Allen, J., Bertolli, J., Moore, C. A., Pereira, I. O.,… Peacock, G. (2017). Health and development at age 19–24 months of 19 children who were born with microcephaly and laboratory evidence of congenital Zika virus infection during the 2015 Zika virus outbreak—Brazil, 2017. MMWR Morbidity and Mortality Weekly Report, 66(49), 1347–1351. https://doi.org/10.15585/mmwr.mm6649a2

  9. Shapiro-Mendoza, C. K., Rice, M. E., Galang, R. R., Fulton, A. C., VanMaldeghem, K., Prado, M. V.,… Meaney-Delman, D. (2017). Pregnancy outcomes after maternal Zika virus infection during pregnancy—U.S. Territories, January 1, 2016–April 25, 2017. MMWR Morbidity and Mortality Weekly Report, 66(23), 615–621.

  10. Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by a cooperative agreement between the Centers for Disease Control and Prevention and the March of Dimes Foundation [Grant #6 NU38OT0001999-05-03, CFDA 93.424]. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Funding

This study was funded by March of Dimes Foundation (1 U380T000199-01).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Linda Squiers.

Ethics declarations

Conflict of interest

These authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Squiers, L., Brown, S., Hauser, K. et al. Perceptions of Health Care, Information, and Social Support Among Women Affected by Zika Virus Infection During Pregnancy in Two U.S. States. Matern Child Health J 25, 1836–1841 (2021). https://doi.org/10.1007/s10995-021-03272-7

Download citation

Keywords

  • Zika
  • Pregnancy
  • Health care
  • Information needs