Experiences Of Maternity Services Research Articles

A Review of Maternity Care for Migrant Women

Migrant women’s experiences of maternity services have been well documented in literature. However, many studies do not account for the impact of migrant women’s language proficiency on their experience with maternity care services. This paper explores the factors contributing to women’s experiences including language barriers, access to care, physical outcomes and emotional outcomes. It provides a comparison of English-speaking native-born women with migrant women of non-English speaking backgrounds (NESB). Through evaluation of the data, the reader will gain an understanding of the needs of migrant women where English was their second language (ESL), to reduce health inequalities and implement system reform.

Adoption of policies to improve respectful maternity care in Timor-Leste.

There are now well-established global standards for supporting improvement in women's experience of maternity services, including frameworks for the prevention of mistreatment during childbirth. To support initiatives to improve the quality of care in maternal health services in Timor-Leste, we examine the adoption of global respectful maternity care standards in the national intrapartum care policy and in three urban birth facilities in Dili. From May to July 2022, we conducted a desk review of the Timor-Leste National Intrapartum Care Standards and Clinical Protocols for Referral Facilities and Community Health Centres. This was followed by a health-facility audit of policies, guidelines and procedures in three main maternity facilities in the capital, Dili to examine the extent to which the WHO (2016) standards for women's experiences of care have been adopted. Despite the availability of global guidelines, key standards to improve women's experience of care have not been included in the National Intrapartum Care guidelines in Timor-Leste. There was no mention of avoiding mistreatment of women, needing informed consent for procedures, or strengthening women's own capability and confidence. In the policy wording, women tended to be distanced from the care 'procedures' and the protocols could be improved by taking a more woman-centred approach. The results of the health facility assessment showed extremely low use of standards that improve women's experiences of care. Health Facility 1 and 2 met two of the 21 quality measures, while Health Facility 3 met none of them. The discourse communicated through policy fundamentally affects how health care issues are framed and how policies are enacted. Given the findings of this study, combined with previously documented issues around quality of care and low satisfaction with maternal health services, there is a need for a fundamental shift in the culture of care for women. This will require an immediate focus on leadership, training and policy-frameworks to increase respectful care for women in health facilities. It will also require longer-term effort to address the power imbalances that drive mistreatment of women within and across social systems, and to support models of care that inherently foster understanding and compassion.

“We need to be heard. We need to be seen”: A thematic analysis of black maternal experiences of birthing and postnatal care in England within the context of Covid-19

ObjectiveInequalities for Black women within maternity settings are longstanding, with evidence showing higher mortality, complications and distress compared to White women. The Covid-19 pandemic saw unprecedented changes to maternity services, with emerging evidence highlighting a disproportionate impact on mothers from ethnically minoritized backgrounds. This uniquely positioned study explores Black women's experiences of services during Covid-19. DesignThe study used a qualitative design with semi-structured interviews, data were analysed using reflexive thematic analysis. SettingThe study took was open to all in the UK, participants who took part were from England and were recruited via social media and community led organisations. ParticipantsThe study recruited 13 self-identifying Black women, aged between 23 and 41 who received maternity care across settings (NHS wards, home birth and birthing centre) across England. Measurement and findingsThree themes were generated from the study: ‘The Ripples of Covid’, ‘Inequality within Inequality’ and ‘Conscientious Change for Maternity Systems’, with sub-themes including the impact of regulations, the invisibility of pain and the importance of accountability. Alongside multiple layers of inequality and emotional labour for Black women, the study found connection and advocacy as facilitators of good care. Key conclusionsSupporting existing research, Black women's experiences of maternity services during Covid-19evidence ongoing of structural racism within maternity provision, founded on stereotypes of strength and pain. Though moments of advocacy and connection, however, Covid-19 appeared exacerbated ongoing existing inequalities for Black women. Changes to service provision contributed to isolation, distress, and consequential inadequate care. Implications for practiceThe findings, generated by Black women, established important implications for practice and policy, including an emphasis on creating conscientious change of systems through a racialised lens, the importance of meaningful equity, representation, and the need for co-production alongside Black communities.

Minoritised ethnic women’s experiences of inequities and discrimination in maternity services in North-West England: a mixed-methods study

BackgroundMinoritised ethnic perinatal women can experience judgemental and stigmatising care due to systemic racism. Discriminatory care contributes to increased risks of poor maternal and infant outcomes, including higher rates of mental ill-health. This study aimed to explore minoritised ethnic women’s experiences of maternity services, including maternity care and mental health support, within a North-West England locality. Here we use an equity lens to report the findings that describe if and how women’s personal, cultural, and spiritual needs were met, their experiences of discriminatory and prejudicial care, and to identify recommendations for service provision.MethodsA mixed-methods study was undertaken comprising an online survey, interviews, and community consultations. Questions explored access to and experiences of antenatal care and education; information, communication, and choice; experiences of (dis)respect and judgement; mental health needs and support; cultural/religious needs and support; and overall experiences of maternity care. Eligibility criteria were: women, 18+ years, from self-reported minoritised ethnic backgrounds, who had given birth in the previous 2 years and received maternity care in the locality. Surveys were available in seven languages and distributed via social media, mother-baby groups, and community locations. English-speaking survey participants were invited to take part in a follow-up interview. Community staff were approached to collect data on behalf of the study team. Quantitative data were analysed descriptively (n, %) and merged with qualitative data into descriptive themes.ResultsOverall, 104 women provided data; most self-identified as Asian (65.0%) or Black (10.7%) and were aged between 30–34 (32.0%) or 25–29 years (23.3%). Four descriptive themes are reported: ‘accessing care’ details variations and barriers in accessing maternity care; ‘communication needs, and resources’ describes views on adaptions and resources for specific communication needs; ‘meeting religious and cultural needs’ outlines how various religious and cultural needs were met by maternity providers; ‘discriminatory or stigmatising care’ reports on experiences of pejorative and inequitable care.ConclusionsAn equity lens helped identify areas of discriminatory and inequitable care. Key recommendations include cultural safety training for staff; service-user engagement and co-production of research and resources, and appropriate facilities and recording systems to facilitate individualised, needs-based maternity care.

Black, Asian and minority ethnic women's experiences of maternity services in the UK: A qualitative evidence synthesis.

AimsBlack, Asian and minority ethnic women are at higher risk of dying during pregnancy, childbirth and postnatally and of experiencing premature birth, stillbirth or neonatal death compared with their White counterparts. Discrimination against women from ethnic minorities is known to negatively impact women's ability to speak up, be heard and their experiences of care. This evidence synthesis analysed Black, Asian and minority ethnic women's experiences of UK maternity services in light of these outcomes.DesignWe conducted a systematic review and qualitative evidence synthesis using the method of Thomas and Harden.Data SourcesA comprehensive search in AMED, Cinahl, Embase, Medline, PubMed and PsycINFO, alongside research reports from UK maternity charities, was undertaken from 2000 until May 2021. Eligible studies included qualitative research about antenatal, intrapartum and postnatal care, with ethnic minority women in maternity settings of the UK NHS.Review MethodsStudy quality was graded using the Critical Appraisal Skills Programme tool.ResultsTwenty‐four studies met the inclusion criteria. Our synthesis highlights how discriminatory practices and communication failures in UK NHS maternity services are failing ethnic minority women.ConclusionThis synthesis finds evidence of mistreatment and poor care for ethnic minority women in the UK maternity system that may contribute to the poor outcomes reported by MBRRACE. Woman‐centred midwifery care is reported as positive for all women but is often experienced as an exception by ethnic minority women in the technocratic birthing system.ImpactEthnic minority women report positive experiences when in receipt of woman‐centred midwifery care. Woman‐centred midwifery care is often the exception in the overstretched technocratic UK birthing system. Mistreatment and poor care reported by many ethnic minority women in the UK could inform the inequalities of outcomes identified in the MBRRACE report.

Experiences of maternity care during the COVID-19 pandemic in the North of England

Background During 2020, UK maternity services made changes to service delivery in response to the COVID-19 pandemic. Aims To explore service users' and their partners' experiences of maternity services in the North of England during the COVID-19 pandemic. Methods Respondents (n=606) completed a co-produced survey during August 2020. Data were analysed using descriptive statistics and content analysis. Findings Five major categories were identified: valuing support from health professionals, feeling lost in and let down by the system, the impact of restrictions to partners and others, virtual contact is not the same as in-person contact, and the need for emotional and psychological wellbeing support. Conclusion The changes implemented may have compromised mental health and wellbeing in a critical period of vulnerability. Bringing stakeholders together can maximise learning from the emergency measures, to better inform future service provision. Work is needed to better hear from minoritised groups and ensure they are not further marginalised by changes.

The perceptions and practices of Thai health professionals providing maternity care for migrant Burmese women: An ethnographic study

BackgroundAcross the globe, many women including economic and humanitarian migrants receive inadequate antenatal care. Understanding the difficulties that migrant women encounter when accessing maternity care, including the approach of health professionals, is necessary because inadequate care is associated with increasing rates of morbidity and mortality. There are very few studies of migrant women’s access to and experience of maternity services when they have migrated from a low- to a middle-income country. AimTo examine the perceptions and practices of Thai health professionals providing maternity care for migrant Burmese women, and to describe women’s experiences of their encounters with health professionals providing maternity care in Ranong Province in southern Thailand. MethodsEthnography informed the study design. Individual interviews were conducted with 13 healthcare professionals and 10 Burmese women before and after birth. Observations of interactions (130 h) between health care providers and Burmese women were also conducted. Data were analysed using thematic analysis. FindingsThe healthcare professionals’ practices differed between the antenatal clinics and the postnatal ward. Numerous barriers to accessing culturally appropriate antenatal care were evident. In contrast, the care provided in the postnatal ward was woman and family centered and culturally sensitive. One overarching theme, “The system is in control’ was identified, and comprised three sub-themes (1) ‘Being processed’ (2) ‘Insensitivity to cultural practices’ and, (3) ‘The space to care’. Discussion and conclusionsThe health system and healthcare professionals controlled the way antenatal care was provided to Burmese migrant women. This bureaucratic and culturally insensitive approach to antenatal care impacted on some women’s decision to engage in antenatal care. Conversely, the more positive examples of woman-centered care evident after birth in the postnatal ward, can inform service delivery.

Reducing maternal mortality in Nigeria: addressing maternal health services’ perception and experience

Despite efforts targeted at addressing maternal deaths across national and sub-national levels, maternal mortality ratio has remained high in Nigeria in the last two decades, with the country currently accounting for about 20% of global maternal deaths. While improving overall quality of healthcare is crucial to addressing the high maternal deaths, some country-specific issues need to be explored. This paper highlights the need to understand and address the perception and experiences of maternal services particularly at point of delivery, as this is imperative towards increasing the utilization of maternal health facilities in a multicultural setting like Nigeria. The focus should not only be on why women do not accept healthcare services, but why health facilities do not provide the services that women will accept. This approach to assessing quality of healthcare is necessary to inform relevant policy and public health response in the country.

The effect of prenatal and intrapartum care on the stillbirth rate among women in rural Ethiopia.

To determine whether community-based prenatal and intrapartum care in Ethiopia results in a lower stillbirth rate. Between May and December 2014, a randomly selected sample of women in northern and eastern Ethiopia who had delivered a neonate in the preceding 12months completed a face-to-face survey about their experiences of maternal services and the fetal outcome for each delivery. The stillbirth rates among women delivering at home and at health facilities were compared. Overall, 4442 women completed surveys. Stillbirth was reported by 42 (1.7%) of the 2437 women who had received prenatal care and 53 (2.8%) of the 1921 women who did not receive prenatal care (P=0.01). The stillbirth rate was similar among women who delivered in a health center (27/1417 [1.9%]), in a hospital (6/126 [4.8%]), and at home (62/2725 [2.3%]; P=0.13). However, women experiencing an intrapartum emergency were twice as likely to deliver in a health facility (odds ratio 2.6, 95% confidence interval 2.2-3.0). Satisfaction with health-center care was moderately good (median score 77.5/100). The stillbirth rate was reduced among women receiving prenatal care, although delivering in a health facility did not reduce the risk of stillbirth. Improving the quality of health-center care could lead to their planned use for childbirth, which might reduce stillbirth rates.

Does Induced Abortion Affect the Experience of Maternity Services?

Does Induced Abortion Affect the Experience of Maternity Services?

Supporting Young Dads' Journeys through Fatherhood.

While the recent Coalition government committed to some initiatives supporting the role of parents, relationships and the early years, there remains a lack of focus on fathers as a distinct policy area. This is reflected at local government level, as lead professionals for young fathers are rare and data on the number of young fathers in each local area are not routinely collected. Barnardo's was funded by the Department for Education in 2012, as part of the Family Strategic Partnership, to highlight the needs and experiences of young fathers in England, and the joint role of statutory and voluntary services in supporting them (fully reported by Barnardo's in Cundy, 2012). Based on selected case studies drawn from research and a range of practice organisations, this article presents the journeys of five young fathers and their experience of maternity services, children's centres, schools, housing services and the secure estate.

Promoting homebirth: Intermediate homebirth report

The publication of the Place of Birth Study ( Birthplace in England Collaborative Group et al, 2011 ) provided the impetus for a West Midlands NHS Trust to develop a long-desired dedicated homebirth team. In 2013, Birmingham Women's hospital successfully bid and won a £750 000 Service Development Improvement Plan from Birmingham South Central Commissioners to lead a 3-year homebirth service pilot project. The aim of the project was to increase the homebirth rate and produce positive results in three key areas: improve women's experience of maternity services, signpost low-risk women out of hospital into the home setting, and improve outcomes and deliver care within tariff. This report reflects on the initial set-up and the launch of the new service.

Pregnancy as an ideal time for intervention to address the complex needs of black and minority ethnic women: Views of British midwives

Introductionmaternal health inequalities exist across the world. In the United Kingdom, whilst there are variations within and between groups, Black and Minority Ethnic (BME) women tend to have worse maternal health outcomes than White British women. However, there is limited information about BME women׳s experience of maternity services. Midwives are central to the provision of safe maternity care but little is known about their perceptions of ethnically-based inequalities in maternal healthcare. Therefore, this study explored a cohort of midwives׳ experiences of providing care for BME women, focussing on their views on the relationship between maternal health inequalities and service delivery. Methodsusing a specifically-designed topic guide, 20 semi-structured interviews were conducted with qualified midwives in one National Health Service (NHS) Trust in the North West of England over a two-month period. Data were subsequently transcribed and thematically analysed. Resultsthree main and seven sub-themes were identified. Firstly, ‘language’ summarised difficulties midwives experienced in engaging with women whose English was limited. Secondly, ‘expectations of maternity care’ outlined the mismatch between midwives and women׳s expectations of maternity care. Finally, ‘complex needs extending beyond maternity care’ highlighted the necessity of inter-agency working to address women׳s care holistically when their needs transcend the scope of maternity services. DiscussionMidwives׳ accounts indicated that they strive to provide equitable care but encountered numerous barriers in doing so. Paradoxically, this might contribute to inequalities in service delivery. In midwives׳ view, unrestricted access to interpretation and translation services is essential for provision of effective, holistic maternity care. Participants also advocated education for both women and midwives. For the former, this would improve BME women׳s understanding of health and care systems, potentially leading to more realistic expectations. Improving midwives׳ cultural competence would better equip them to respond to the needs of an ethnically diverse population. Finally, midwives highlighted that many minority women׳s complex care needs were identified during pregnancy. Hence, they regarded pregnancy as an ideal time for interventions to improve the health of women and their families and, as such, antenatal care cannot be treated as an isolated event. According to midwives in this study, delivering safe, effective maternity services in the 21st century requires greater collaboration with the women they care for and other health and care agencies (including independent sector providers).

Making sense of the situation: Women's reflection of positive fetal screening 11–21 months after giving birth

Objectivewe aimed to gain insights into women's reflection on their experience of receiving a false-positive screening result for fetal anomalies, more than 11 months from birth. Design and settingthe women constituted a subgroup of participants in a larger cohort study (n=1111) where the purpose was to explore women's experience of maternity services, their health, well-being, attitudes and expectations during pregnancy and after birth. Semi-structured interviews were collected from 14 women 11–21 months after birth who had been screened positive for fetal chromosomal abnormality in early pregnancy. The method of life-world phenomenological approach was used in data collection and analyses. Findingfour themes were identified: first reaction, framing of the news, I am not an island and pregnancy lost and regained. With few exceptions, their experience can be seen as a pathway from shock to balanced feeling where women have made sense of what happened and have dealt adequately with their situation. Conclusionthis study indicates that few women still experience anxiety and concerns in relation to positive fetal screening result more than 11 months from birth. They however remember vividly their first reaction and how the result was presented. As such, the findings have implications in the clinical context meaning that framing of the news on face-to-face level, extended information about the test results, help to sort out mixed feelings and support from a named midwife are of importance.

Achieving a positive balance

British Journal of MidwiferyVol. 21, No. 11 BirthwriteAchieving a positive balanceCathy WarwickCathy WarwickSearch for more papers by this authorCathy WarwickPublished Online:18 Nov 2013https://doi.org/10.12968/bjom.2013.21.11.766AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References National Perinatal Epidemiology Unit (2012) The Birthplace cohort study: Key findings. www.npeu.ox.ac.uk/birthplace/results (accessed 22 October 2013) Google ScholarNational Federation of Women's Institutes and NCT (2013) Support Overdue: Women's experiences of maternity services. NCT, London Google ScholarRoyal College of Midwives (2013) Evidence to the NHS Pay Review Body for 2014. RCM, London Google ScholarRoyal College of Midwives, Birthchoice UK (2013) Trends in Freestanding Midwife-led Units in England and Wales 2001-2013. RCM, London Google ScholarSandall J, Soltani H, Gates S, Shennan A, Devane D (2013) Midwife-led continuity models versus other models of care for childbearing women. The Cochrane Library 3: CD004667 Google ScholarTracy SK, Hartz DL, Tracy MB, Allen J, Forti A, Hall B, White J, Lainchbury A, Stapleton H, Beckmann M, Bisits A, Homer C, Foureur M, Welsh A, Kildea S (2013) Caseload midwifery care versus standard maternity care for women of any risk: [email protected], a randomised controlled trial. The Lancet 382: DOI: 10.1016/s0140-6736(13)61406-3 Crossref, Google Scholar FiguresReferencesRelatedDetailsCited byPriority issues from 0–199 March 2015 | British Journal of Midwifery, Vol. 23, No. 3Joint call for addressing issues in the 0–19 health-care service16 March 2015 | British Journal of School Nursing, Vol. 10, No. 2Priority issues from 0–1920 March 2015 | Journal of Health Visiting, Vol. 3, No. 3 1 November 2013Volume 21Issue 11ISSN (print): 0969-4900ISSN (online): 2052-4307 Metrics History Published online 18 November 2013 Published in print 1 November 2013 Information© MA Healthcare LimitedPDF download

Immigrant women's experience of maternity services in Canada: A meta-ethnography

Objectiveto synthesise data on immigrant women's experiences of maternity services in Canada. Designa qualitative systematic literature review using a meta-ethnographic approach Methodsa comprehensive search strategy of multiple databases was employed in consultation with an information librarian, to identify qualitative research studies published in English or French between 1990 and December 2011 on maternity care experiences of immigrant women in Canada. A modified version of Noblit and Hare's meta-ethnographic theoretical approach was undertaken to develop an inductive and interpretive form of knowledge synthesis. The seven-phase process involved comparative textual analysis of published qualitative studies, including the translation of key concepts and meanings from one study to another to derive second and third-order concepts encompassing more than that offered by any individual study. ATLAS.ti qualitative data analysis software was used to store and manage the studies and synthesise their findings. Findingsthe literature search identified 393 papers, of which 22 met the inclusion criteria and were synthesised. The literature contained seven key concepts related to maternity service experiences including social (professional and informal) support, communication, socio-economic barriers, organisational environment, knowledge about maternity services and health care, cultural beliefs and practices, and different expectations between health care staff and immigrant women. Three second-order interpretations served as the foundation for two third-order interpretations. Societal positioning of immigrant women resulted in difficulties receiving high quality maternity health care. Maternity services were an experience in which cultural knowledge and beliefs, and religious and traditional preferences were highly relevant as well but often overlooked in Canadian maternity settings. Key conclusions and implications for practicein order to implement woman-centered care, to enhance access to maternity services, and to promote immigrant women's health, it is important to consider these women's social position, cultural knowledge and beliefs, and traditional customs in the health care.

Migration and Maternity: Insights of Context, Health Policy, and Research Evidence on Experiences and Outcomes From a Three Country Preliminary Study Across Germany, Canada, and the United Kingdom

A group from Germany, Canada, and the United Kingdom undertook country-specific scoping reviews and stakeholder consultations before joining to holistically compare migration and maternity in all three countries. We examined four interlinking dimensions to understand how international migrant/minority maternal health might be improved upon using transnational research: (a) wider sociopolitical context, (b) health policy arena, (c) constellation, outcomes, and experiences of maternity services, and (d) existing research contexts. There was clear evidence that the constellation and delivery of services may undermine good experiences and outcomes. Interventions to improve access and quality of care remain small scale, short term, and lacking in rigorous evaluation.

Ethnic minority women's experience of maternity services in England

Objectives. Provision for ethnic minority groups has been acknowledged as integral to good maternity care in England and ethnicity has been highlighted as an indicator of both poorer clinical outcomes and poorer experiences. Improving outcomes and services is dependent on understanding women's interaction with both service delivery and provision. The aim of this study was to explore Black and minority ethnic (BME) women's experiences of contemporary maternity care in England. Design. A UK-wide survey which investigated core aspects of maternity care sought the views of BME women about their experiences. A random sample of women were selected by the Office for National Statistics from birth registration in England and invited to complete a questionnaire three months after the birth. In a secondary analysis, text responses to open-ended questions about their maternity care were analysed using thematic analysis. Results. Sixty per cent of the 368 women who self-identified as BME responded with open text. Themes that emerged related to ‘feeling cared for,’ with subthemes of ‘expectations of care’ and ‘policies, rules and organisational pressures’; ‘staff attitudes and communication’ with sub-themes of ‘please believe me,’ ‘hospital as a safe place,’ ‘choices denied’ and ‘being sensitive and supportive would help,’ and ‘ethnicity and culture’ with sub-themes of ‘stereotyping’ and ‘improving the quality of care.’ Conclusion. The findings highlight issues affecting the quality of maternity care that BME women in England receive. Many issues are not unique to BME women; however, the findings reflect some seemingly enduring issues and coherence with other wider international findings, particularly in relation to post-natal care and staff attitudes. Actually being cared for and supported across their child-bearing experience are needs that women themselves identified as critical for care providers to recognise and respond to. The failures of care provision described should inform the development of services.

Maternity services in multi-cultural Britain: Using Q methodology to explore the views of first- and second-generation women of Pakistani origin

Objective to explore first- and second-generation Pakistani women’s experiences of maternity services and the inter generational differences/comparisons. Design a retrospective Q methodology study of Pakistani women following childbirth. Setting two Children's Centres in an inner city in the West Midlands. Participants women self-identified following distribution of information leaflets at Children’s Centres. Fifteen women took part in interviews (Stage one) using a semi-structured design and 16 women participated in the completion of the Q grid sorting (Stage four). Methods a standard five-stage Q methodology process took place: (1) initial data were gathered using a combination of individual face-to-face and focus group semi-structured community-based interviews (developing the concourse); (2) transcribed interviews were analysed for ‘themes’; (3) the themes were reduced to ‘statements’ that reflected the overall content of the concourse using an unstructured evolving approach (giving the Q set); (4) participants were asked to sort the statements (Q sorting) according to a pre-designed distribution grid providing individual participant response grids; and (5) the response grids were factor analysed using PQ Method (V2.11), which generates clusters of participants rather than clusters of variables. Factor loadings were calculated using factor analysis by principal components with varimax rotation. This produced a list of factors, each of which represents a ‘story’ of women’s experiences of maternity services. Throughout the process, an Urdu interpreter was involved. Findings six factors were identified: (1) confidence and empowerment of women who had attended higher education and had family support; (2) isolation of some women from both family and maternity services; (3) women who had poor experiences of maternity services but good family support, and wanted opportunities to be involved in service development; (4) women with positive experiences of maternity care and influenced by traditional cultural practices; (5) importance of information and support from health-care professionals; and (6) importance of midwifery care to women. Conclusion there were no clear inter generational differences identified, but a breadth of opinion and experience that seemed to be influenced by level of both education and social support was found. Whereas some women had few demands of maternity services, those who had less support and those with language barriers had additional needs. Implications for practice care given should be based on individual need but given within a wider collaborative context in order to support women effectively. Increased maternity service user involvement would also be welcomed for future planning of maternity services.

Mothers’ experiences of maternity services: internal consistency and test–retest reliability of the Greek translation of the Kuopio Instrument for Mothers

Objective the Kuopio Instrument for Mothers (KIM) questionnaire assesses mothers’ experiences of maternity services during pregnancy and delivery. The aim of this study was to translate the questionnaire into Greek, and to evaluate the internal consistency and test–retest reliability of the Greek version of the KIM. Methods 77 mothers completed both the test and the retest questionnaire. The KIM includes the Utah Test for the Childbearing Year (UTCY) and four other scales. Internal consistency was assessed using Cronbach's alpha. Test–retest reliability was assessed using intraclass correlation coefficients, kappa coefficients ( κ) and Pearson correlation coefficients ( r). Findings strong correlation ( r=0.793, p<0.001) was found between the total test mean score (88.22±5.82) and the total retest mean score (87.49±6.16) for the UTCY. Cronbach's alpha ranged from 0.74 for the UTCY to 0.75 for the 26-item scale on discussion of topics in maternity welfare clinics, 0.85 for the 10-item scale on mother–obstetrician collaboration, 0.94 for the 14-item scale on mother–midwife collaboration, and 0.55 for the seven-item scale on provision of services for women. The κ coefficients ranged from 0.325 to 0.924. Conclusions the questionnaire appears to be a reliable measure of mothers’ experiences in the Greek population. Further studies are needed to refine the instrument.