Women's Satisfaction Research Articles

Women’s Unpaid Work as a Factor of Gender Inequality: A Case of Kazakhstan

Purpose: This paper explores diverse issues related to the problem of women’s unpaid domestic care work, and as a factor of gender inequality in their professional practice. Research Design: This article concentrated only on the analysis of secondary data available on the topic along with observation of facts in Kazakhstan based on diverse sources. In current conditions, the problem of women's unpaid domestic care work, and consequently, the lack of enough time and energy for professional employment. Distinguish domestic work vs. job/career/occupation, selffulfillment, education, and leisure has a significant impact on women's life satisfaction. Data, and Methodology: This article focuses only on secondary data available in different sources from which the researchers procures comprehensive data and information. Results and conclusion: A family policy that aims to promote combining maternity, and domestic work with paid employment is an effective way to increase the proportion of working mothers/women. It is crucial to not only proportionally distribute the household responsibilities in the family but also to form an effective mechanism of state support for women through the development of the social services sector, as well as the adoption of a system-wide approach to gender equality.

Comparative Efficacy of Vaginal Misoprostol vs Vaginal Dinoprostone Administered 3 Hours Prior to Copper T380A Intrauterine Device Insertion in Nulliparous Women: A Randomized Controlled Trial.

To compare the effectiveness of misoprostol and dinoprostone tablets administered vaginally 3hours before copper intrauterine device (IUD) insertion vs placebo in reducing pain and increasing ease of insertion among nulliparous women. Randomized controlled trial. Tertiary referral hospital. A total of 129 nulliparous women requesting a Copper T380A IUD insertion. Women were randomized to receive 200μg misoprostol or 3mg dinoprostone or placebo 3hours before IUD insertion. Primary outcome was patient-reported pain during IUD insertion using a 10-cm visual analog scale (VAS). Secondary outcomes include provider ease of insertion, women satisfaction level, and side effects. Participants' baseline characteristics were comparable between the study groups. Mean pain score during IUD insertion was lower with misoprostol than placebo (3.1±2.3 vs 4.4±2.2; P=.02) and dinoprostone compared to placebo (2.4±1.8 vs 4.4±2.2; P<.001). Clinicians reported easier IUD insertion with misoprostol than placebo (2.4±1.7 vs 4.0±2.4; P=.001) and dinoprostone compared to placebo (2.0±1.5 vs 4.0±2.4; P<.001). Women's satisfaction levels were higher with both misoprostol and dinoprostone than placebo (P<.001). Side effects did not differ among the 3 study groups. Premedication with vaginal misoprostol or dinoprostone effectively lowered pain during copper IUD insertion. However, the reduction in pain scores was clinically significant only in women who received dinoprostone. In both the misoprostol and dinoprostone groups, clinicians found the procedure easier, and women were more satisfied with IUD insertion. Side effects and complications were similar in all groups.

Transgender women's satisfaction with healthcare services: A mixed-methods pilot study.

Many transgender women are dissatisfied with healthcare services PURPOSE: (a) To describe satisfaction/dissatisfaction with healthcare services; and (b) to describe barriers/facilitators of satisfaction with healthcare services among a sample of transgender women. A mixed methods design collected quantitative data (n = 50) and qualitative data (n = 25) from transgender women. Quantitatively, satisfaction with healthcare services was high among the participants, with lower areas related to healthcare systems issues. Qualitatively, participants identified barriers and facilitators of healthcare satisfaction. This study provides clinical, research, educational, and policy implications for improving healthcare satisfaction among transgender women.

Utilisation of antenatal care services as determinants of satisfaction and its challenges in Lagos, Nigeria

Despite the growing interest and efforts by government to popularise antenatal care services in Nigeria as recommended by the World Health Organization, high levels of infant and maternal mortality remains a major public health challenge facing the country. Complications of pregnancy and childbirth cause more deaths and disabilities than any other reproductive health problems in African countries, including Nigeria. Antenatal care presents an opportunity for recognition and appropriate intervention for some of the causes of maternal mortality in developing countries. The study investigates the level of utilisation of antenatal care services as determinants of satisfaction and its challenges among pregnant women in Lagos, Nigeria. A multistage sampling technique was used to determine the sample size of 1 500 pregnant women. A validated questionnaire was used for data collection. The Cronbach's alpha reliability coefficients for the tools ranged from 0.94–0.97. Data were analysed using descriptive and inferential (correlation, simple and multiple regression) statistics. The results showed that utilisation of antenatal care services had a significant influence on pregnant women's satisfaction with the services. Long waiting hours in the clinic, income/financial constraints, high cost of services and distance to health centres are the major challenges faced by pregnant women in Lagos.

Evaluation of the Preoperative Perception of Quality of Life and Satisfaction of Women With Breast Cancer Using the BREAST-Q™ Questionnaire

IntroductionAlmost 40% of women who undergo breast surgery are dissatisfied with the decision-making process as well as cosmetic results. Our objective was to demonstrate the usefulness of the BREAST-Q™ preoperative questionnaire to evaluate the satisfaction and health-related quality of life in women with diagnosis of breast cancer prior to surgery, as well as identifying satisfaction profiles. MethodsProspective cohort observational study in women with breast cancer, evaluating preoperative quality of life using the BREAST-Q™ questionnaire. Percentile measures for each domain and baseline physical characteristics were assessed for posterior analysis. ResultsThe average score in the breast satisfaction domain was 58.9±16.9. The average score in the preoperative psychosocial well-being domain was 70.5±16.1. Patients who were offered conservative surgery had a mean physical well-being score of 80.7±18.5, and those who were offered mastectomy had an average score of 79.9±17.7. The sexual well-being average score was 63.2±20.7. No statistically significant differences were found between low-score and high-score groups regarding epidemiological and clinical characteristics. ConclusionsPreoperative evaluation in breast cancer patients provides correct assessment of the effect of surgical treatment on patient satisfaction and quality of life. This information is useful for communicating with patients about their expectations and postoperative results.

Satisfaction of Slovak women with psychosocial aspects of care during childbirth

ObjectiveThe objective of the study is to find out and assess satisfaction of Slovak women with psychosocial aspects of perinatal care. Design and settingThe research was designed as a quantitative cross-sectional study. The research data were collected in five pediatric outpatient clinics in Slovakia. ParticipantsThe research sample consisted of 360 women within 0–1 year after natural delivery (average time in months from childbirth: 6.22 ± 3.64) who visited the selected pediatric outpatient clinic in the period from October 2016 to January 2018. MethodsTo collect the relevant data, the original Czech questionnaire measuring psychosocial climate in maternity hospitals – KLI-P (Cronbach α = 0.95) was used to investigate the satisfaction of women with care during labor and delivery as well as with psychosocial aspects. The following six factors were assessed: (1) helpfulness and empathy of midwives and (2) of physicians, (3) superiority and lack of interest, (4) physical comfort and services, (5) control of a woman in labor and her participation in decision-making, (6) providing information. The received data were analyzed using descriptive statistics, the Shapiro–Wilk test, robust ANOVA, Post-hoc test, the Wilcoxon two-sample test, a G-test of independence and the Cochran–Armitage test of trend. FindingsWe found that most women (83.1%) were generally satisfied with their care during labor and delivery as well as with psychosocial support. In terms of psychosocial aspects, the highest level of satisfaction was attributed to the approach of the health professionals and the lowest one (61.5%) to the control and participation of delivering woman in decision-making. Both perception of the course of labor and delivery and skin-to-skin contact immediately after birth were shown to be statistically significant predictors of women's satisfaction. The aspect of age was found to be statistically significant in relation to the factor of control of a woman in labor and her participation in decision-making. Key conclusions and implications for practiceIt can be concluded that it is necessary to pay attention to the psychosocial aspects of health care during labor and delivery, with the emphasis on strengthening interventions in the field of participation of women in decision-making. Simultaneously, it is beneficial to emphasize and support the naturalness of childbirth so that women would associate childbirth with a positive experience. Finally, it is important to promote skin-to-skin contact right after birth.

Patient Satisfaction with Outpatient Cervical Ripening in Parous Women.

This study aimed to assess whether patient satisfaction differs between women beginning cervical ripening in the outpatient versus inpatient setting. We performed a planned secondary analysis evaluating patient satisfaction randomized to outpatient versus inpatient cervical ripening. In the original randomized controlled trial, low-risk parous women ≥39 weeks who required cervical ripening for induction and had reassuring fetal heart rate monitoring were included and randomized to inpatient versus outpatient ripening with a transcervical Foley's catheter. All women were then admitted to the labor ward on the following day. Patient satisfaction was evaluated using three separate surveys. The first two surveys, Six Simple Questions and Lady-X, were previously validated. The third survey used visual analog scales to assess overall pain experienced during Foley's placement, overall pain experienced during labor, how likely they would be to choose the same type of care for their next pregnancy, and how likely they would be to recommend their method of cervical ripening to friends/family. From May 2016 to October 2017, 129 women were randomized (outpatient, 65; inpatient, 64). Based on survey results, there was no difference in satisfaction between outpatient and inpatient cervical ripening with transcervical Foley's catheterization, with high satisfaction in both groups. Patients in both the outpatient and inpatient groups would choose the same type of care for their next pregnancy (on a scale of 1-7, median (25th-75th percentile): 7 [7-7] vs. 7 [6-7], respectively, p = 0.75) and would be very likely to recommend their method of induction to a friend or family member (on a scale of 0-100, 99 [80-100] vs. 99 [65-100], respectively, p = 0.60). Parous women's satisfaction does not differ between inpatient and outpatient cervical ripening with transcervical Foley's catheterization. · Outpatient cervical ripening may allow providers to incorporate the benefits of electively inducing women as well as decrease the time spent in the labor and delivery unit.. · Parous women's satisfaction does not differ between inpatient and outpatient cervical ripening with transcervical Foley.. · Additional prospective evaluation is warranted to further characterize patient preferences in relation to the location of cervical ripening..

Effect of Intrapartum Clinical Pathway Application on Maternity Nurses' Performance and Women Satisfaction

A clinical pathway is a multidisciplinary management tool based on evidence-based practice in which the different tasks interventions by the professionals involved in the patient care are defined, optimized. It can be utilized in education and facilitate access to care and providing improved outcomes for patients and increasing women and staff satisfaction. Aim: The study aimed to evaluate the effect of clinical pathway application on maternity nurses' performance of intrapartum care and women's satisfaction. Design: A quasi-experimental design was used. Settings: This study was applied in gynecology and obstetrics departments affiliated with Tanta University Hospital. Sample: A purposive sample of 60 maternity nurses and 120 intrapartum women were recruited in this study. Six tools were used for Data Collection: a structured interviewing questionnaire for the nurses, a structured interviewing questionnaire for the intrapartum women and clinical pathway checklist for maternity nurses, an observational checklist for women, a Numeric Pain Intensity Scale, and maternal satisfaction with hospital based intrapartum care scale. Results: Statistically significant differences were found between pre and post-implementation of the clinical pathway reflected by higher knowledge and performance score for nurses' improvement in the maternity nurses' knowledge regarding all items of the postpartum clinical pathway after the intervention than before the intervention. The majority of nurses adequately done all items of newborn care; assessment of newborn, suctioning, Apgar score, cord care, eye care, measurements, body temperature, vitamin K administration , and identification. Also, only (8%) of the intrapartum women suffered from severe pain in a clinical pathway group compared to 38% routine care group. In addition, intrapartum women's satisfaction in the study group has improved. Conclusion: using of clinical pathway had a positive effect in improving the maternity nurses' performance and women satisfaction of intrapartum care post clinical pathway application than pre-intervention. Recommendations: Training programs should be implemented for maternity nurses about intrapartum care based on the clinical pathway to improve nurses' performance.

The Effectiveness of Mindfulness-Based Cognitive Therapy on Sexual Disorders and Sexual Satisfaction in Women with spouses’ extra-marital relationships

The Effectiveness of Mindfulness-Based Cognitive Therapy on Sexual Disorders and Sexual Satisfaction in Women with spouses’ extra-marital relationships

Benefits of Self-administered Vaginal Dinoprostone 12 Hours before Levonorgestrel-releasing Intrauterine Device Insertion in Nulliparous Adolescents and Young Women: A Randomized Controlled Trial.

To assess safety and efficacy of self-administered vaginal dinoprostone 12hours before a 52-mg levonorgestrel intrauterine device (LNG-IUD) insertion in adolescents and young nulliparous women. Randomized controlled trial. Tertiary referral hospital. Nulliparous adolescents and young women aged 18-22years. Participants were randomly assigned into 2 groups; the dinoprostone group (n=65) received dinoprostone 3mg vaginally, and the placebo group (n=65) received placebo tablets vaginally. Primary outcome was pain scores during LNG-IUD insertion measured using a visual analogue scale. Secondary outcomes were pain scores during speculum insertion, tenaculum placement, uterine sounding, and 20minutes postprocedure, ease of insertion, Women's satisfaction score, need for additional analgesics, and side effects. The dinoprostone group had significantly lower pain scores during LNG-IUD insertion (2.83±1.08 vs 3.95±1.63), tenaculum placement (2.97±1.41 vs 4.55±1.53) and sounding of uterus (3.55±1.71 vs 5.12±1.37) compared with the placebo group (P<.001). No significant differences were found between both groups regarding anticipated pain scores (P=.85), pain during speculum insertion and 20minutes postinsertion and insertion duration (P=.53). Women's satisfaction, provider reported ease of insertion, and need for additional analgesia were significantly better among dinoprostone users (P<.001, < .001, and .02, respectively). Side effects and procedure complications were similar for the 2 groups. Self-administered dinoprostone 3mg vaginally 12hours before a 52-mg LNG-IUD insertion in nulliparous adolescent and young women effectively reduced pain during insertion and increased women's satisfaction and ease of insertion reported by clinicians.

Population-based Data at Ages 31 and 46 Show Decreased HRQoL and Life Satisfaction in Women with PCOS Symptoms.

Polycystic ovary syndrome (PCOS) is associated with decreased health-related quality of life (HRQoL), but longitudinal data beyond the reproductive years are lacking, and the impact of isolated PCOS symptoms is unclear. To study generic HRQoL using the 15D questionnaire, life satisfaction, and self-reported health status in women with PCOS symptoms at ages 31 and 46 years. A longitudinal assessment using the Northern Finland Birth Cohort 1966. General community. The 15D data were available for women reporting isolated oligo-amenorrhea (OA; at age 31 years, 214; and 46 years, 211), isolated hirsutism (H; 31 years, 211; and 46 years, 216), OA + H (PCOS; 31 years, 74; and 46 years, 75), or no PCOS symptoms (controls; 31 years, 1382; and 46 years, 1412). Data for life satisfaction and current health status were available for OA (31 years, 329; and 46 years, 247), H (31 years, 323; and 46 years, 238), PCOS (31 years, 125; and 46 years, 86), control (31 years, 2182; and 46 years, 1613) groups. None. 15D HRQoL, questionnaires on life satisfaction, and self-reported health status. HRQoL was lower at ages 31 and 46 in women with PCOS or H than in the controls. PCOS was an independent risk factor for low HRQoL, and the decrease in HRQoL in PCOS was similar to that of women with other chronic conditions, such as asthma, migraine, rheumatoid arthritis, and depression. The risk for low HRQoL in PCOS remained significant after adjusting for body mass index, hyperandrogenism, and socioeconomic status. Mental distress was the strongest contributing factor to HRQoL. PCOS was also associated with a risk for low life satisfaction and a 4-fold risk for reporting a poor health status. Women with PCOS present with low HRQoL, decreased life satisfaction, and a poorer self-reported health status up to their late reproductive years. Assessments and interventions aiming to improve HRQoL in PCOS should be targeted beyond the fertile age.

Perinatal contraceptive counselling: Effectiveness of a reinforcement intervention on top of standard clinical practice

ObjectiveTo assess the effectiveness of supplemental perinatal contraceptive counselling in addition to standard Spanish postpartum contraceptive counselling with regard to contraceptive use and use of effective contraception up to 1 year postpartum. Women's satisfaction with counselling and the method chosen was also assessed. DesignCommunity-randomized trial. Setting“Reproductive and Sexual Health Care” units of the National Health Care System at twenty public Primary Care facilities in Catalonia (Spain). Participants1,004 consecutive pregnant women (~week 30) receiving prenatal care between 1st October 2015 and 31st March 2016. Women were considered eligible for analysis if appropriate information was available. InterventionsAt half of the centres, midwives provided the standard Spanish postpartum contraceptive counselling (control group, CG). At the other half, supplemental perinatal contraceptive counselling was provided in addition to standard counselling (intervention group, IG) at different time points during pregnancy and postpartum. This consisted of a leaflet and a blog with practical information about all contraceptive options plus a short reminder message in the mobile phone during the third quarter of pregnancy and a face-to-face or a virtual meeting lasting 20 min in the first 15 days postpartum. Midwives used ad hoc questionnaires to collect information at week 30 of pregnancy (recruitment), and week 6, month 6 and month 12 postpartum. Measurements and findings975 women were eligible for analysis (482 in the CG and 493 in the IG). ~33% women had resumed sexual intercourse by week 6, and nearly all by months 6 and 12. Use and effectiveness of contraceptives was similar in both groups at week 6 and month 6. At month 12, more women in the IG used more effective contraception and less women used contraceptives considered somewhat effective vs. those of the CG (P = 0.006). When considering the place of origin, this was only true for Spanish women. Women of other origins had a much higher use of very effective contraceptives at month 12 also in the CG, with contraceptive counselling having scarce effect. On multivariate analysis, conducted only in Spanish women, the additional counselling resulted in a higher use of highly effective methods while having a university degree increased 3.6 times the OR for this behaviour. A bias towards fostering use of very effective contraceptives among women with low education was seen in standard clinical practice. Satisfaction with counselling and the type of contraception chosen was higher in the IG. Key conclusionsOur study has shown that the supplemental counselling tested has a moderate impact on contraceptive use and use of effective contraception in postpartum women. Results of this effort were seen after 6 months postpartum. A possible bias towards women who were more socially vulnerable was found in standard clinical practice, which reduced the effectiveness of the intervention in women who were otherwise the most needy. Implications for practiceDespite the benefits provided by supplemental support in perinatal contraceptive counselling, the existence of a possible bias affecting the effectiveness of these interventions should be investigated and addressed.

Duration of labor, delivery mode and maternal and neonatal morbidity after remifentanil patient-controlled analgesia compared with epidural analgesia.

ObjectiveThe objective of this study was to compare duration of active labor, delivery mode, maternal and neonatal morbidity and women’s satisfaction with delivery after intravenous remifentanil patient-controlled analgesia (PCA) or standard epidural analgesia (EDA). Based on clinical observations, we hypothesized that women with PCA would have shorter labor.Study designAn observational study at a university hospital in Sweden 2009–16. Maternal and neonatal outcomes with PCA (n = 69) and EDA (n = 138) were compared.ResultsWomen with PCA had shorter active labor 5.6 ± 3.3 compared to 8.5 ± 4.4 h (p < 0.001) with EDA, and a higher rate of spontaneous delivery 94% (65/69) compared to 65% (n = 90/138) with EDA (p < 0.001). Intrapartum temperature >38 °C (p = 0.001) and signs of fetal asphyxia (p < 0.001) were less common with PCA. No maternal or neonatal sedation was observed. The rates of transient oxygen desaturation <95%, bleeding > 1000 mL and women’s satisfaction with delivery did not differ between the groups.ConclusionPCA had several advantages over EDA, as it was associated with shorter active labor and a higher rate of spontaneous delivery without worsening maternal or neonatal morbidity or women’s satisfaction with delivery. Therefore, we suggest an increased availability of PCA for labor analgesia. We recommend continuous one-to-one care and oxygen saturation monitoring for all women during active labor.

The Role of Body Shame in Sexual, Relationship, and Life Satisfaction in Women

ABSTRACTThe purpose of this study was to measure how body shame, sexual satisfaction, and relationship satisfaction predicted life satisfaction for female participants who have been in committed relationships for at least a year and who have engaged in sexual activity with their partners (N = 138). Researchers examined data to determine how body shame may interact with: (a) sexual satisfaction, (b) relationship satisfaction, and (c) life satisfaction. Results indicate that body shame and relationship satisfaction account for the greatest amount of variance in life satisfaction for the respondents.

Social support and satisfaction with antenatal care services among pregnant women in Lagos State, Nigeria

Background/AimsMaternal and infant mortality remains a major public health challenge in Nigeria. Provision of cognitive support through effective communication with women about their condition or the care required is a critical determinant of satisfaction with maternal care. Effective antenatal care is important in reducing the maternal mortality rate. This study aimed to assess social support and satisfaction with antenatal care services among pregnant women, to improve antenatal care services and birth outcomes.MethodsThis study used a survey research design where 1316 questionnaires were completed by pregnant women across six general hospitals in Lagos State, Nigeria. Participants rated their social support when deciding to use antenatal care services and their satisfaction with these services. Regression analysis was used to determine the association between social support and satisfaction with antenatal care services.ResultsThe degree of social support received by pregnant women was very high (average score of 3.51 on a 4-point scale). The level of satisfaction with antenatal care services was also very high (average score of 4.32 on a 5-point scale). Linear regression showed that social support has a significant influence on pregnant women's satisfaction with antenatal care services in Lagos State (r=0.307, P&lt;0.000).ConclusionThe degree of social support was a significant determinant of satisfaction with antenatal care services. It is therefore recommended that social support for women to attend these services is encouraged.

Psychometric properties of the Iranian version of Birth Satisfaction Scale-Revised.

Background:The precise measurement of childbirth satisfaction demands a reliable tool specifically designed for maternal care and birth satisfaction. It was designed to measure the degree of women's satisfaction with childbirth. The purpose of the present study was to translate and analyze the psychometric properties of the Birth Satisfaction Scale-Revised (BSS-R) in Iranian women.Materials and Methods:This is a methodological cross-sectional study. Five health centers in various regions of Kashan were affiliated to Kashan University of Medical Sciences, Kashan, Iran. Two hundred and twelve mothers who were referred to the health centers and had childbirth during the last year were included. The face and content validity were obtained after backward–forward translation of the Iranian version of BSS-R by 12 faculty board members in midwifery and reproductive health fields. The construct validity of the tool was determined using confirmatory factor analysis on 212 women in the postpartum period. The internal consistency and reliability of the tool was evaluated by Cronbach's alpha coefficient and intraclass correlation coefficient (ICC). The collected data were analyzed in SPSS (version 16.0) and EQS 6.1.Results:The result of face and content validity was minor modifications in some words. Confirmatory analysis results indicated that there was an acceptable fit with a three-factor model. Cronbach's alpha was estimated for the whole tool 0.74, and the alpha of the three subscales ranged from 0.698 to 0.801. ICC for determining reliability was 0.77.Conclusion:The Iranian version of BSS-R was a reliable and valid tool for assessing the women's satisfaction with their childbirth care.

Assessment of birth satisfaction among the women attending the immunization clinics in South Delhi: A cross-sectional study

Background: A woman's satisfaction with childbirth services can have a significant impact on her mental health and ability to bond with her neonate. Indian women's satisfaction with childbirth services has been explored qualitatively, or by using nonstandard local questionnaires, but quantitative data gathered with standardized questionnaires are extremely limited Objective: The aim of this study is to assess the birth satisfaction level among women of South Delhi with institutional normal vaginal delivery and to determine the factors associated with it. Materials and Methods: A cross-sectional study was conducted among the 102 mothers attending the immunization clinics of a primary care and a tertiary care center in South Delhi during March 2018–April 2018. A prevalidated, semi-structured, Hindi version 36-item Scale, with 10 domains, Scale for Measuring Maternal Satisfaction in normal birth was used. Statistical Analysis: Pearson Chi-square, Mann–Whitney test, and Fisher's exact test were applied as tests of significance. Results: The median age in completed years of the respondents was 24 years (interquartile range = 5). Majority, 58 (61.1%), of the participants, were more satisfied. Bribes were asked from 61.1% of the mothers. Demanding bribes, perceived competence of healthcare providers by the mothers, and the motivation given by others were significantly associated with the individual domains of birth satisfaction such as postpartum care satisfaction and overall support received. No significant association between the sociodemographic, birth time events and overall birth satisfaction levels was obtained. Conclusion: About 38.9% less satisfied mothers and the domain-specific associated factors give the scope for the areas to be worked on to improve the quality of maternal and patient-centric services. Hospitals should publicly declare and implement zero tolerance for bribes in the care of mothers.

A Shared Decision-Making Toolkit for Mode of Birth After Cesarean.

This study evaluated a shared decision-making (SDM) Toolkit (decision aid, counseling guide, and provider scripts) designed to prepare and engage racially diverse women in shared decision-making discussions about the mode of birth after cesarean. The pilot study, involving 27 pregnant women and 63 prenatal providers, assessed women's knowledge, preferences, and satisfaction with decision making, as well as provider perspectives on the Toolkit's acceptability. Most women experienced knowledge improvement, felt more in control and that providers listened to their concerns and supported them. Providers reported that the Toolkit helped women understand their options and supported their counseling. The SDM Toolkit could be used to help women and providers improve their SDM regarding mode of birth after cesarean.

Birth satisfaction among low risk women in a Public Healthcare Center in India

Women's satisfaction with the care they receive during childbirth has gained importance in recent years. Factors such as women's stress experienced during labour, anxiety and feeling of being in control during labour have not been widely studied in India even though these factors influence satisfaction with birth. This study aims to assess women's satisfaction with care following normal birth in a secondary level public facility using the Birth satisfaction Scale Revised (BSS R). Consecutive samples of 273 low risk women who have had spontaneous vaginal birth were enrolled within 1 week of childbirth. Demographic profile was collected, and women were assessed for satisfaction at birth using the BSS R. The total birth satisfaction score was 21.4 (±4.5), which is just around the mean of the total score. The women scored below average in the sub domain of stress experiences during labour (7.0 ± 2.6). The domain on women's' personal attributes was also rated poorly (2.8 ± 1.5). The quality of care provision was rated above average by the women (11.6 ± 2.7). A significant difference in the mean score of BSS R was seen in relation to educational status of the women and the type of family they belonged to (P < 0.05). Assessment of birth satisfaction can assist in focusing on areas where improvement in care is required. Midwives need to educate and partner with women right from the antenatal period to make labour and childbirth a satisfying experience for the woman.

Maternal Satisfaction and Associated Factors Among Pregnant Women Attended at Antenatal Care Service in Bedessa Health Center, Wolaita Zone, Ethiopia, 2018

Background: Client satisfaction is indispensable for further advancement of the quality of focused antenatal care service and women's satisfaction has been directly linked to the quality of services given. This is essential to meet specific client needs and to provide uniform health care services for pregnant women. Objective:-To assess maternal satisfaction and associated factors among pregnant women attending Antenatal care service in Bedessa Health center, Wolaita Zone, Ethiopia, 2018. Methods: Facility-based cross-sectional study using quantitative methods was conducted among 387 pregnant women’s. Subjects were selected using systematic random sampling technique. Data were coded, cleaned and entered by using Epi info version 7.2 and analyzed using SPSS version 20, and Bivariate and multiple logistic regression were carried out to identify factors associated with client satisfaction on antenatal care services and strength of association were declared at significance level of 0.05. Result: More than half of the respondents (64.1%) were satisfied with the service that they received. Those pregnant mothers who were merchants were three times more likely satisfied than housewife’s (AOR=2.649, 95%CI: 1.008, 6.96). Mothers who had first visit ANC were almost three times more likely satisfied than those who had a fourth visit (AOR=2.85, 95%CI: 1.383, 5.90) and mothers who had second visits were two times more likely satisfied than those who had four visits (AOR=2.14, 95%CI: 1.09, 4.21). Conclusions and Recommendation: The level of satisfaction was lower compared to other studies. Client feedback should be recognized as a legitimate method of evaluating health services in the health center as a whole.