• Laura Iannuzzi, Lucia Branchini, Jette A Clausen, Dolores Ruiz-Berdún, Patricia Gillen, Maria Healy, Katrien Beeckman, Anna Seijmonsbergen-Schermers, Ramon Escuriet Peiró, Sandra Morano, Mariarosaria Di Tommaso, and Soo Downe.
• Physiological Pregnancy Pathway and Margherita Birth Center, Department of Health Care Professions, Careggi University Hospital, Florence, Italy - lauraiannuzzi@gmail.com.
• Minerva Ginecol. 2018 Dec 1; 70 (6): 650-662.

BackgroundThe publication of the World Health Organization (WHO) recommendations on antenatal care in 2016 introduced the perspective of women as a necessary component of clinical guidelines in maternity care. WHO highlights the crucial role played by evidence-based recommendations in promoting and supporting normal birth processes and a positive experience of pregnancy. This paper aims to explore and critically appraise recommendations of national antenatal care guidelines across European countries in comparison with the WHO guideline.MethodsWe collected guidelines from country partners of the EU COST Action IS1405. Components of the documents structure and main recommendations within and between them were compared and contrasted with the WHO guideline on antenatal care with a particular interest in exploring whether and how women's experience was included in the recommendations.ResultsEight out of eleven countries had a single national guideline on antenatal care while three countries did not. National guidelines mostly focused on care of healthy women with a straightforward pregnancy. The level of concordance between the national and the WHO recommendations varied along a continuum from almost total concordance to almost total dissonance. Women's views and experiences were accounted for in some guidelines, but mostly not placed at the same level of importance as clinical items.ConclusionsFindings outline convergences and divergences with the WHO recommendations. They highlight the need for considering women's views more in the development of evidence-based recommendations and in practice for positive impacts on perinatal health at a global level, and on the experiences of each family.

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