The Patient's Perspective and Patient Satisfaction in Labor and Delivery [35N

Abstract

INTRODUCTION: Clinical and subjective factors affect the patient's perception of labor and delivery, but little is known about how much each factor contributes to patient satisfaction. This study evaluates the correlation between clinical and subjective patient parameters during the intrapartum course and patient satisfaction. METHODS: This is a cross-sectional observational study. Participants completed surveys in the immediate postpartum period. Surveys assessed the patient's perception of intrapartum events and patient satisfaction. Survey responses were compared to patient charts. Logistic regressions determined predictors of patient satisfaction. RESULTS: 332 women completed surveys. Positive subjective factors which predicted patient satisfaction included feeling the provider explained the intrapartum course well (OR 3.47, 95% CI 1.17–10.31, P=.025), patient input into managing labor (OR 2.96, 95% CI 1.46–5.98, P=.002), and increased support during labor (OR 2.45, 95% CI 0.99–6.04, P=.05). Having a birth plan led to less satisfaction (OR 0.49, 95% CI 0.24–0.96, P=.04). Birth classes and feeling pressured by providers in labor were not significant predictors of patient satisfaction. Positive clinical predictors of patient satisfaction included a vaginal delivery (OR 1.97, 95% CI 1.07–3.27, P=.02), but multiparity, advanced maternal age, regional anesthesia, episiotomy, or a postpartum hemorrhage were not significant predictors of satisfaction. Understanding the labor and delivery events predicted high satisfaction (P=.02). CONCLUSION: Patient satisfaction is dependent on patient input into labor, adequate explanations of the labor course, increased support in labor, high patient understanding, and achieving a vaginal delivery.