Gaining insight into how women conceptualize satisfaction: Western Australian women's perception of their maternity care experiences.

Lucy Lewis,Fiona Ronchi,Yvonne L Hauck,Caroline Crichton,Liana Waller

doi:10.1186/s12884-015-0759-x

Lucy Lewis, Fiona Ronchi + Show 3 more

Open Access

https://doi.org/10.1186/s12884-015-0759-x

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Abstract

BackgroundThe concept of maternal satisfaction is challenging, as women’s and clinicians’ expectations and experiences can differ. Our aim was to investigate women’s experiences of maternity care in an urban tertiary obstetric setting, to gain insight into conceptualization of satisfaction across the childbirth continuum.MethodsThis mixed method study was conducted at a public maternity hospital in Western Australia. A questionnaire was sent to 733 women two weeks post birth, which included an invitation for an audio-recorded, telephone interview. Frequency distributions and univariate comparisons were employed for quantitative data. Thematic analysis of interview transcripts was undertaken to extract common themes.ResultsA total of 54 % (399 of 733) returned the questionnaire. Quantitative results indicated that women were less likely to feel: involved if they did not have a spontaneous vaginal birth (P = 0.020); supported by a midwife if they had a caesarean (P = <0.001); or supported by an obstetrician if they had a spontaneous vaginal birth (P = <0.001).Qualitative findings emerged from 63 interviews which highlighted the influence that organization of care, resources and facilities had on women’s satisfaction. These paradigms unfolded as three broad themes constructed by four sub-themes, each illustrating a dichotomy of experiences. The first theme ‘how care was provided’ encompassed: familiar faces versus a different one every time and the best place to be as opposed to so disappointed. The second theme ‘attributes of staff’ included: above and beyond versus caring without caring and in good hands as opposed to handled incorrectly. The third theme ‘engaged in care’ incorporated: explained everything versus did not know why and had a choice as opposed to did not listen to my needs.ConclusionsQuantitative analysis confirmed that the majority of women surveyed were satisfied. Mode of birth influenced women’s perception of being involved with their birth. Being able to explore the diversity of women’s experiences in relation to satisfaction with their maternity care in an urban, tertiary obstetric setting has offered greater insight into what women value: a sensitive, respectful, shared relationship with competent clinicians who recognise and strive to provide woman focused care across the childbirth continuum.

Highlights

The concept of maternal satisfaction is challenging, as women’s and clinicians’ expectations and experiences can differ
Two decades ago a large Australian survey found that women experience greater satisfaction with their antenatal opposed to intrapartum care [6]
This study was performed at the sole public tertiary obstetric hospital in Western Australia (WA) for women with complex pregnancies; recent data from the ‘Safe Tracking Obstetric Record Keeping’ database at the study centre found in 2012, 23 % of all births were preterm

Summary

Introduction

The concept of maternal satisfaction is challenging, as women’s and clinicians’ expectations and experiences can differ. Our aim was to investigate women’s experiences of maternity care in an urban tertiary obstetric setting, to gain insight into conceptualization of satisfaction across the childbirth continuum. It is unusual for a woman to feel completely satisfied with every aspect of her care. More likely she will rank the quality of her care as satisfactory, but when asked to reflect on her experience she can often share what she liked and disliked [5]. Two decades ago a large Australian survey found that women experience greater satisfaction with their antenatal opposed to intrapartum care [6]. Women who have increased obstetric intervention such as induction of labour are generally less satisfied with their care [8]. A study comparing satisfaction with mode of birth found most women prefer a vaginal birth and that maternal satisfaction with vaginal birth was high [9]

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