Does model of care affect women's health and wellbeing in the perinatal period in Sweden?

Abstract

Background/Aims Self-rated health before, during and after pregnancy is important for women's quality of life and promotes bonding between mother and child. However, diverse aspects of care models influence women's experiences during pregnancy. This study aimed to investigate low-risk women's self-rated health during the perinatal period in relation to different models of care in Sweden. Methods A retrospective study was conducted of computerised obstetric data from 167 523 women with low-risk pregnancies during 2010–2015. Descriptive analysis was used, as well as group comparisons and ordinal regression analysis, to establish links between self-rated health before, during and after pregnancy and sociodemographic characteristics. Results The majority of women, regardless of model of care, rated their health as very good or good before, during and after pregnancy. During pregnancy, primiparous women, those who attended <7 midwife visits and those followed up by a private centre were more likely to rate their health as good. Women who had more than four midwives, were under the age of 30 years or foreign-born had increased risk of rating their health as bad. Postnatally, women who used private care, primiparous women and those aged 25–29 years were at lower risk of rating their health as bad. Conclusions Women attending private healthcare services tended to rate their health as better. Vulnerable groups of women need special attention from healthcare authorities.