Abstract
BackgroundAssessment of quality of life after childbirth is an important health-outcome measurement for new mothers and is of special interest in midwifery. The Mother-Generated Index (MGI) is a validated instrument to assess postnatal quality of life. The tool has not been applied for making a cross-cultural comparison before. This study investigated (a) responses to the MGI in German-speaking women in Germany and Switzerland; and (b) associations between MGI scores on the one hand and maternity and midwifery care on the other.MethodsA two-stage survey was conducted in two rural hospitals 10 km apart, on opposite sides of the German-Swiss border. The questionnaires included the MGI and questions on socio-demographics, physical and mental health and maternity care, and were distributed during the first days after birth and six weeks postpartum. Parametric and non-parametric tests were computed with the statistical programme SPSS.ResultsA total of 129 questionnaires were returned an average of three days after birth and 83 in the follow-up after seven weeks. There were no statistically significant differences in the MGI scores between the German and the Swiss women (p = 0.22). Significantly more favourable MGI scores were found associated with more adequate information during pregnancy (p = 0.02), a more satisfactory birth experience (p < 0.01), epidural anaesthesia (p < 0.01), more information (p = 0.01) and better support (p = 0.02) during the time in hospital and less disturbed sleep (p < 0.01). Significantly lower MGI scores were associated with the presence of a private doctor during birth (p = 0.01) and with exclusive breastfeeding during the first postnatal days (p = 0.04).ConclusionThe MGI scores of these German-speaking women were higher than those in other studies reported previously. Thus the tool may be able to detect differences in postnatal quality of life among women with substantially divergent cultural backgrounds. Shortcomings in maternity and midwifery care were detected, as for example the inadequate provision of information during pregnancy, a lack of individualised postpartum care during the hospital stay and insufficient support for exclusively breastfeeding mothers. The MGI is an appropriate instrument for maternity care outcome measurement in cross-cultural comparison research.
Highlights
Assessment of quality of life after childbirth is an important health-outcome measurement for new mothers and is of special interest in midwifery
Associations between variables relating to pregnancy, labour, birth, the postpartum period and care processes on the one hand and differences in postnatal quality of life on the other have not been investigated before
The aims of this study were (a) to investigate how the primary and secondary Mother-Generated Index (MGI) scores as well as a number of identified areas of life differed between women giving birth in the German and the Swiss hospital; and (b) to correlate MGI scores with variables relating to antenatal, intrapartum and postpartum care
Summary
Assessment of quality of life after childbirth is an important health-outcome measurement for new mothers and is of special interest in midwifery. The Mother-Generated Index (MGI) is a validated instrument to assess postnatal quality of life. Assessing postnatal quality of life for cross-cultural comparison provides information on gaps in maternity care. Due to the lack of uniform definition and the subjective nature of quality of life, its assessment is challenging. The Mother-Generated Index (MGI) was developed by Symon et al [9] as the first tool designed to assess postnatal quality of life. The tool does not provide a predefined checklist of problems, and respects the subjective nature of quality of life and measures aspects of it as the mother perceives them [9]. Associations between variables relating to pregnancy, labour, birth, the postpartum period and care processes on the one hand and differences in postnatal quality of life on the other have not been investigated before
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