Abstract
BackgroundMaternity care reform plans have been proposed at state and national levels in Australia, but the extent to which these respond to maternity care consumers’ expressed needs is unclear. This study examines open-text survey comments to identify women’s unmet needs and priorities for maternity care. It is then considered whether these needs and priorities are addressed in current reform plans.MethodsWomen who had a live single or multiple birth in Queensland, Australia, in 2010 (n 3,635) were invited to complete a retrospective self-report survey. In addition to questions about clinical and interpersonal maternity care experiences from pregnancy to postpartum, women were asked an open-ended question “Is there anything else you’d like to tell us about having your baby?” This paper describes a detailed thematic analysis of open-ended responses from a random selection of 150 women (10% of 1,510 who responded to the question).ResultsFour broad themes emerged relevant to improving women’s experiences of maternity care: quality of care (interpersonal and technical); access to choices and involvement in decision-making; unmet information needs; and dissatisfaction with the care environment. Some of these topics are reflected in current reform goals, while others provide evidence of the need for further reforms.ConclusionsThe findings reinforce the importance of some existing maternity reform objectives, and describe how these might best be met. Findings affirm the importance of information provision to enable informed choices; a goal of Queensland and national reform agendas. Improvement opportunities not currently specified in reform agendas were also identified, including the quality of interpersonal relationships between women and staff, particular unmet information needs (e.g., breastfeeding), and concerns regarding the care environment (e.g., crowding and long waiting times).
Highlights
Maternity care reform plans have been proposed at state and national levels in Australia, but the extent to which these respond to maternity care consumers’ expressed needs is unclear
The study sample appeared characteristically similar to the total population of women birthing in Queensland in 2010 (n 61,027); [18] the majority of women were aged between 25 and 39 years, were multiparous, and gave birth in public hospitals
Information provided was contradictory, lacked sufficient detail or timing, or was withheld based on false assumptions. These findings indicate that goals of ‘access’ [8], ‘consumer involvement and choice’ and improving postnatal service delivery in current reform plans [7,2] are critical for addressing the primary deficiencies noted by women in this study, and hinge on the provision of adequate and appropriate information
Summary
Maternity care reform plans have been proposed at state and national levels in Australia, but the extent to which these respond to maternity care consumers’ expressed needs is unclear. This study examines open-text survey comments to identify women’s unmet needs and priorities for maternity care. It is considered whether these needs and priorities are addressed in current reform plans. Objectives for maternity care reform that have arisen from such enquiry include improved: monitoring (e.g. the ongoing assessment of workforce needs) [2], Women’s maternity care experiences in Queensland, Australia, are influenced by both state and national policy and legislation, and reforms have been proposed at both levels.
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