Abstract
BackgroundThe World Health Organization recommends good practices for the conduct of uncomplicated labor and birth, with the aim of improving the quality of and assessment by women of childbirth care. The aim of this study was to evaluate the association between adoption of good practices according to WHO’s recommendation for normal labor and birth and assessment by women of the care received.MethodsBirth in Brazil is a national hospital-based study with countrywide representation consisting of 23,894 mothers and their newborns, conducted between February 2011 and October 2012. The present study analysed a subsample of this national survey. Postpartum women classified as low risk during pregnancy who had experienced either spontaneous or induced labor were included in this study, totalling 4102 mothers. To estimate the association between assessment by women of the childbirth care received (dependent variable) and good practices according to WHO’s recommendation during normal labor and birth (independent variables), a multinomial logistic regression analysis was used and crude and adjusted odds ratios calculated with their 95 % confidence intervals.ResultsThe good practices associated with positive assessment of the care received by women during labor and birth included the partner’s presence, privacy in the birthing place, time available to ask questions, clarity of information received, and empathic support from caregivers during labor and birth. Freedom of movement, free nutrition offered, choice of companions, nonpharmacological analgesia, skin-to-skin contact and breastfeeding in the childbirth room were not associated with the assessment by women of the care received.ConclusionsOur findings reveal the importance to mothers of their relationship with the team of caregivers during labor and birth. Therefore, caregiver teams must be qualified within a more humanistic vision of childbirth health care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-016-0233-x) contains supplementary material, which is available to authorized users.
Highlights
The World Health Organization recommends good practices for the conduct of uncomplicated labor and birth, with the aim of improving the quality of and assessment by women of childbirth care
This study demonstrated that a good relationship established between women and their health care team during labor and birth is a decisive factor for positive assessment of the care received
In this study, the way women assessed their care during labor and birth was influenced by good practices related to how they were treated by the medical team, clarity of information received, the empathic and respectful support of health care providers, and the presence of a companion during labor and birth
Summary
The World Health Organization recommends good practices for the conduct of uncomplicated labor and birth, with the aim of improving the quality of and assessment by women of childbirth care. A negative assessment is associated with unfavorable outcomes such as psychological problems in the postpartum period (postnatal depression and post-traumatic stress disorder), preference for cesarean section, negative feelings and thoughts about the infant, and breastfeeding problems [3,4,5]. For these reasons, the women’s assessment about the childbirth care provided have been increasingly considered important feedback for policy makers, managers, and other professionals involved in maternal health care [1, 6]. Expectations and feelings about pregnancy may influence the way puerperal women assess childbirth care received [7,8,9]
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