Assessing the perception of the childbirth experience in Italian women: A contribution to the adaptation of the childbirth perception questionnaire

Birth outcomes associated with a natural delivery approach in a perinatal center: A comparative retrospective study

OBJECTIVES

At our center, natural home-like delivery settings have been established in or near conventional labor wards, for the care of pregnant women who prefer little or no medical intervention during labor and birth. We compared obstetrical and neonatal outcomes of women in active spontaneous labor, between those who chose to deliver in a natural-delivery setup and those who chose a conventional setting.

METHODS

This retrospective study included low-risk women who delivered at term between March 1, 2020 and December 31, 2022, in a single tertiary university affiliated medical center. Birth outcomes were compared between 124 women who delivered by natural birth (the study group) and 244 who gave birth in a conventional setting (the control group).

RESULTS

No cesarean deliveries were performed in the study group, compared to 18 (7.4%) of the control group, p = 0.004. Intrapartum fever, postpartum hemorrhage, and uterotonic administration were similar between the groups. For the study compared to the control group, breastfeeding was more common (71.3% vs. 12.3%, p < 0.001), analgesia administration within 48 h delivery was lower (4.1% vs. 10.7%, p = 0.033), and maternal and neonatal length of hospitalization were shorter. Of the women initially admitted to the natural-delivery room, 14 (11.5%) were transferred to a conventional-delivery room.

CONCLUSIONS

Birth in a hospital natural-delivery setting was associated with increased likelihood of vaginal birth, increased immediate breastfeeding and breastfeeding at discharge, and lower postpartum pain.

Maternal satisfaction on delivery service and associated factors among mothers delivered at Arba Minch town governmental health facilities, South Ethiopia: A cross-sectional study

Objective

To assess maternal satisfaction with delivery service and associated factors among mothers delivered at Arba Minch town governmental health facilities, South Ethiopia, 2022.

Methods

A facility-based cross-sectional design study was conducted from 1 April to 30 June 2022. The total sample size was 320. A systematic random sampling technique was used to select mothers. Data were entered using Epi-data Version 3.1 and exported to SPSS Version 25 for analysis. Multicollinearity was considered using a variance inflation factor. The goodness of fit test was done using the Hosmer-Lemeshow model. Binary logistic regression was done, and variables with a p-value of <0.25 in the bivariable analysis were taken into the multivariable analysis. Statistically significant was declared at a p-value of <0.05 with an adjusted odds ratio and 95% confidence interval.

Result

The maternal satisfaction with delivery service was 75.0% (95% CI: 70.3%-79.4%). Being urban residence (AOR: 4.15, 95% CI: 1.87-9.19), absence of anemia during pregnancy (AOR: 2.38, 95% CI: 1.07-5.29), absence of antepartum hemorrhage (AOR: 2.96, 95% CI: 1.35-6.50), induction to onset labor (AOR: 0.08, 95% CI: 0.02-0.39), female sex of the newborn (AOR: 0.33, 95% CI: 0.15-0.72), absence of fetal distress during labor (AOR: 5.01, 95% CI: 1.69-14.86), absence of intrauterine meconium release (AOR: 2.77, 95% CI: 1.02-7.63), and presence of privacy measures during examination (AOR: 3.11, 95% CI: 1.37-7.04) were associated with maternal satisfaction.

Conclusion and recommendation

About 8 in 10 mothers are satisfied with the delivery service. Residence, anemia during pregnancy, antepartum hemorrhage, the onset of labor, sex of the newborn, fetal distress during labor, intrauterine meconium release, and privacy measures during examination are associated with maternal satisfaction with delivery services. Therefore, preventing anemia during pregnancy and antepartum hemorrhage, minimizing induction of labor, preventing fetal distress and intrauterine meconium release during labor, and taking privacy measures during examination might enhance maternal satisfaction with delivery services.

Cultural adaptation and psychometric evaluation of Childbirth Experience Questionnaire 2 in Karnataka state, India

BACKGROUND

Women's birthing experience is a sensitive indicator of the quality of childbirth care and can impact the physical and mental health of both women and their neonates. Negligible evidence exists on Indian women's birth experiences and-to the best of authors' knowledge-no questionnaire has been tested in India for measuring women's birthing experiences. This study aimed to test the construct validity and reliability of the Kannada-translated Revised Childbirth Experience Questionnaire.

METHODOLOGY

A cross-sectional survey was carried out among postnatal women (n = 251, up to six months postpartum, with a live healthy neonate) who had given birth at a public or private health facility using the Kannada-translated CEQ2 in two districts of Karnataka. Data were collected at participants' homes after seeking written informed consent. Model fit was determined by Confirmatory Factor Analyses.

RESULTS

The 4-factor model of the CEQ2 showed good fit after deletion of one item (item 8, subcategory "participation") with CMIN = 1.33; SRMR = 0.04; GFI = 0.92, CFI = 0.98, TLI = 0.99, RMSEA = 0.037 and p value 0.002). The Cronbach alpha values were acceptable for the four subscales (0.92, 0.93, 0.97, 0.91) as well as for the overall 21-item scale (0.84).

CONCLUSIONS

The Kannada-translated CEQ2 is a reliable tool to measure the childbirth experiences among Kannada-speaking women and can serve as a reliable ongoing evaluation of women's birth experiences.

Forms of Support and Experiencing Maltreatment and Disrespect During Childbirth at a Health Facility: A Self-Reported Cross-Sectional Study in Ghana

One method to enhance maternal health outcomes in underdeveloped nations is to help women and encourage them to give birth in medical facilities (skilled delivery). Yet, impediments to facility birth have reportedly included fear of abuse and contempt during labour and delivery. The purpose of this study was to evaluate the self-reported experiences of postnatal women and the types of abuse and disrespect they encountered during delivery. One hundred and thirteen (313) women were chosen at random from three healthcare facilities in the Greater Accra area for a cross-sectional study. STATA 15 was used to analyze the data. According to the study, more than half of the postnatal women (54.3%) were urged to have support people present during labour and delivery. Approximately 75.7% said they had been mistreated in some way, with physical violence accounting for 19.8% and undignified care for 9.3%. About 7.7% (n  =  24) of the women were detained or confined against their will. The study's findings indicate that labour-related abuse and disrespect are common. Without improving the birthing experience for women, expanding medical facilities might not result in the skilled or facility-based deliveries that are intended. The quality of maternal health care should be monitored, and hospitals should train their midwives in providing excellent patient care (customer care).

Development of the short form Iranian women childbirth experience questionnaire: a confirmatory factor analysis approach item reduction

INTRODUCTION

Considering that childbirth experience has short- and long-term effects on women's lives, it is necessary to examine their delivery experiences. This study aimed to prepare the short form of a 52-item Iranian women's childbirth experience questionnaire with seven factors: professional support, preparation, control, positive perception, baby, family support, and fear.

METHODS

This methodological research was conducted on women aged 15 to 49 years (n = 770) with uncomplicated vaginal delivery. The short form of the Iranian women's childbirth experience questionnaire was prepared in four stages. The first stage was exploratory factor analysis, conducted on 250 samples, the second stage was confirmatory factor analysis which was performed on 260 samples, independent of the first stage, to report goodness and fit indices, and the third stage employed items from modification indices, expected parameter change, and standardized residual covariance, leading to the short form of Iranian women childbirth experience questionnaire. Finally, confirmatory factor analysis was run on 260 samples, independent of the previous two stages, to confirm the short form and compare it with the original questionnaire for psychometric analysis.

RESULTS

In the exploratory factor analysis stage, nine items with a factor load of less than 0.4 were removed, and the number of domains was reduced to five. The second stage showed that the questionnaire had a goodness of fit index. However, the third stage resulted in removing 11 overlapping items and making a short questionnaire with 33 items. Finally, the confirmatory factor analysis in the last stage showed appropriate goodness of fit for the short form of the Iranian women's childbirth experiences questionnaire (𝛘²/df = 2.352, CFI = 0.881, PCFI = 0.750, RMSEA = 0.072, SRMR = 0.0862).

CONCLUSION

The short form of the Iranian women's childbirth experiences questionnaire enjoyed from an appropriate psychometric evaluation. It is recommended when applying the original questionnaire is not feasible due to lack of time.

Determinants of Maternal Satisfaction with the Quality of Childbirth Services in a University Hospital in Kumasi, Ghana: A Cross-Sectional Study

Introduction. Rendering quality childbirth services that lead to higher levels of maternal satisfaction is an important goal of every health institution. Despite efforts at enhanced client satisfaction over the years, there are still some quality concerns for health policymakers and managers to address. This study sought to assess maternal satisfaction with childbirth services at a university hospital in Kumasi, Ghana. Methods. We conducted a facility-based cross-sectional study among women in postnatal wards after delivery at the University Hospital, Kwame Nkrumah University of Science and Technology. They were recruited using a systematic sampling method, and their perspective about the quality of childbirth services was assessed using a service quality (SERVQUAL) tool. Linear regression analysis was performed to identify the relationship between SERVQUAL attributes and maternal satisfaction. Statistical significance was set at $p$ value < 0.05 at a 95% confidence interval. Results. Of the 277 participants interviewed, 79.8% (221) were satisfied with the childbirth services. Delays (49.5%), unprofessional conduct from health workers (7.2%), poor facilities (10.8%), and an inadequate number of skilled staff (15.5%) were identified as the challenges mothers encountered at the facility. After adjusting for all the components of the SERVQUAL model, reliability (adjusted $\beta =-3.28$ , $p=0.001$ ) and empathy (adjusted $\beta =2.21$ , $p=0.028$ ) were the most significant predictors of maternal satisfaction with childbirth services. Conclusion. Majority of postnatal women were generally satisfied with the overall childbirth services they received at the University Hospital. The service quality components that significantly predicted maternal satisfaction with childbirth services were “reliability” and “empathy.”

Predictors of maternal role adaptation in Iranian women: a cross-sectional study

BACKGROUND

Numerous factors play a role in maternal identity formation and function. Recognizing the aspects related to adaptation to the mother role can effectively provide a solution to help mothers construct maternal roles. Consequently, this study aimed to determine the predictors of adaptation to the maternal role in Iranian women.

METHODS

This cross-sectional study was performed on 564 women who gave birth within one to four months after delivery with a record in Tabriz-Iran health centers, 2020-21. Participants were selected by cluster sampling. Data were collected using questionnaires of socio-demographic and obstetrics characteristics, Birth Satisfaction Scale-Revised (BSS-R), Lipz Maternal Self-Confidence Scale (LMSCS), and maternal role adaptation questionnaire. The general linear model was used to estimate the effect of each of the independent variables (socio-demographic and obstetrics characteristics, childbirth satisfaction, and self-confidence) on the dependent variable (maternal role adaptation).

RESULTS

The mean (± SD) total scores of adaptation to the maternal role, childbirth satisfaction, and maternal self-confidence were 77.4 (± 15.2) (score range: 33-165), 17.0 (± 5.9) (score range: 0-40), and 65.1 (± 13.5) (score range: 24-144), respectively. Based on the Pearson correlation test, there was a significant direct correlation between the overall score of adaptation to the maternal role with childbirth satisfaction (r = 0.462, P < 0.001) and maternal self-confidence (r = 0.652, P < 0.001). Based on the adjusted general linear model, the variables of maternal self-confidence, childbirth satisfaction, adequacy of household income, and spouse support were predictors of adaptation to the mother role. They explained 50.6% of the variance in the adaptation to the mother role score.

CONCLUSIONS

Concerning the study results, adaptation to the maternal role is related to childbirth satisfaction and some socio-demographic variables. Therefore, considering the impact of maternal role on other aspects of women's life and child care, healthcare providers' and policymakers' critical role is to create positive childbirth experiences and strengthen mothers' self-confidence.

Psychometric properties of the Malay version Women's Views of Birth Postnatal Satisfaction Questionnaire using the Rasch measurement model: a cross-sectional study

Background

Maternal satisfaction must be assessed in order to reflect the quality of care, which is considered an outcome of healthcare services. It can also be used to contrast and compare satisfaction with various care models or service configuration or to assess overtime changes. The purpose of this study was to investigate the psychometric properties of the Malay version Women’s Views of Birth Postnatal Satisfaction Questionnaire (WOMBPNSQ) based on the Rasch scale model of labour satisfaction.

Methods

This is a cross-sectional study. Postpartum women were identified from a tertiary hospital and evaluated at 1-month postnatal period using WOMBLSQ. The Rasch model was used to investigate the reliability, unidimensionality, item and person misfits and distribution map.

Results

A total of 195 women were involved. The Rasch analysis revealed that the 30 items had a high level of reliability at 0.99 and item separation at 9.02. It has a low level of reliability at 0.45 and persons separation at 0.90. All the items are considered fit. Five people have most misfitting response strings based on item IPS_Q15, ‘I was given little advice on contraception following the birth of my baby’, but extremely trivial differences were found in the parameter estimates after refitting the model. The more difficult item to endorse satisfaction is item CA_Q17 ‘I was given little advice on contraception following the birth of my baby’.

Conclusions

The WOMBLSQ tested in postpartum women proved to have high item reliability index but with an adequate sample. The analysis shows that the 30 items target the right form of respondents, have similar latent characteristics of postpartum women and a shared sense of satisfaction. For future improvement, more difficult items endorsing satisfaction should be created, and the common items in which satisfaction is expected should be reduced.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-04184-8.

Predictors of fear of childbirth and depressive symptoms among pregnant women: a cross-sectional survey in Pwani region, Tanzania

BACKGROUND

Many women experience fear of childbirth (FoB) and depressive symptoms (DS) during pregnancy, but little is known about FoB among Tanzanian women. The current study aimed to assess the prevalence of FoB and DS among pregnant women and determine predictors of each and both, focusing on sociodemographic and obstetric predictors.

METHODS

A cross-sectional study was conducted at six health facilities in two districts in Tanzania between 2018 and 2019. In total, 694 pregnant women with gestational age between 32 and 40 weeks and expecting vaginal delivery were consecutively recruited and assessed for FoB and DS. We collected data through interviews using 6 and 4-points Likert Scale of the Wijma Delivery Expectancy Questionnaire Version A and Edinburgh Postnatal Depression Scale, respectively. Women who scored ≥66 and ≥ 10 were categorised as having FoB and DS, respectively. We performed multivariable logistic regression to investigate the predictors of FoB and DS.

RESULTS

The prevalence rates of FoB and DS among pregnant women were 15.1 and 17.7%, respectively. FoB and DS were more likely in women aged above 30 years [Adjusted Odds Ratio (AOR) 6.29, 95%CI 1.43-27.84] and in single mothers (AOR 2.57, 95%CI 1.14-5.78). Women with secondary education and above (AOR 0.22, 95%CI 0.05-0.99) and those who had given birth previously (AOR 0.27, 95% CI 0.09-0.87) were less likely to have FoB in combination with DS Women who had previous obstetric complications, and those who did not receive any social support from male partners in previous childbirth were more likely to have FoB and DS. FoB was strongly associated with DS (AOR 3.42, 95%CI 2.12-5.53). DS only was more common in women who had inadequate income (AOR 2.35, 95%CI 1.38-3.99) or had previously experienced a perineal tear (AOR 2.32, 95%CI 1.31-4.08).

CONCLUSIONS

Not having a formal education, having only primary education, being aged above 30 years, being single, being nulliparous, having experienced obstetric complications, and having a lack of social support from a male partner during previous pregnancy and childbirth were predictors of FoB and DS during pregnancy. FoB and DS were strongly associated with each other. It is vital to identify at-risk women early, to offer support during pregnancy and childbirth.

Validation and factor structure of the Italian version of the Birth Satisfaction Scale-Revised (BSS-R)

OBJECTIVE

To validate the Italian-language version of the Birth Satisfaction Scale-Revised (BSS-R) and report key measurement properties of the tool. To evaluate the impact of antenatal class attendance on BSS-R assessed birth satisfaction.

BACKGROUND

Maternal satisfaction is one of the standards of care defined by the World Health Organisation (WHO) to improve the quality of services. The BSS-R is a multi-dimensional self-report measure of the experience of labour and birth.

METHODS

Cross-sectional instrument evaluation design examining factor structure and key aspects of validity and reliability. Embedded between-subjects design to examine known-group discriminant validity and the impact of antenatal class attendance on BSS-R sub-scale and total scores as dependent variables. After giving birth, 297 women provided data for analysis.

RESULTS

The Italian version of the BSS-R (I-BSS-R) was the key study measure. The established three-factor and bi-factor models of the BSS-R were found to offer an excellent fit to the data. Comparison of the tri-dimensional measurement model and the bi-factor model of the BSS-R found no significant differences between models. Women who attended antenatal classes had significantly lower stress experienced during childbearing sub-scale scores (I-BSS-R SE), compared to those who did not. Good convergent, divergent validity and known-groups discriminant validity were established for the I-BSS-R. Internal consistency observations were found to be sub-optimal in this population.

CONCLUSIONS

On all key psychometric indices, with the exception of internal consistency that requires further investigation, the I-BSS-R was found to be a valid translation of the original BSS-R. The impact of antenatal classes on birth satisfaction warrants further research.

Associated factors of labor satisfaction and predictor of postnatal satisfaction in the north-east of Peninsular Malaysia

INTRODUCTION

Identifying the factors contributing to maternal satisfaction is a proxy measure to improve the quality of care. It evaluates the health service provision by understanding maternal perceptions and expectations and promoting adherence to health services. This study aimed to identify the sociodemographic, obstetric, and medical factors contributing to labor satisfaction among postpartum women and examine the association between labor and postnatal satisfaction.

METHODOLOGY

A cross-sectional study using systematic random sampling in a ratio of 1:5 based on the delivery list in a labor room in a tertiary hospital was applied. Information was obtained from medical records for sociodemographic characteristics and obstetric and medical histories. Face-to-face interviews were performed to obtain responses for Malay versions of the Women's Views of Birth Labour Satisfaction Questionnaire and the Women's Views of Birth Postnatal Satisfaction Questionnaire. Simple and general linear regression analyses were performed.

RESULTS

A total of 110 participants responded, accounting for a response rate of 100%. High-risk color codes, the period of gestation, household income, and were significantly associated with maternal satisfaction during labor. The association between labor and postnatal satisfaction was significant.

CONCLUSION

Identifying these associated factors and differences may lead to understanding and contributing to specific and targeted strategies for tackling issues related to maternal satisfaction.

Perceived satisfaction of women during labour at the Hospital Universitario Materno-Infantil of the Canary Islands through the Childbirth Experience Questionnaire (CEQ-E)

OBJECTIVE

To determine the degree of satisfaction of women after childbirth at the Hospital Universitario Materno-Infantil of Gran Canaria (HUMIC) and to establish possible relationships between the degree of satisfaction and the variables studied.

METHOD

A cross-sectional, descriptive, observational study with an analytical component. The study population comprised women who gave birth at the HUMIC in November 2018, recruited through consecutive non-probabilistic sampling. The Spanish version of the Childbirth Experience Questionnaire (CEQ-E) was used (questionnaire with 4 domains: own capacity', professional support, perceived safety and participation/analytical model 2). In a first phase a descriptive analysis was made, and in a second phase an inferential analysis to explore the association between different variables.

RESULTS

The total sample comprised 257 women (n=257). The total score using the CEQ was 3.24 (SD .37 points). No statistically significant differences were found in the final CEQ score between the women who had a spontaneous delivery versus induction-stimulation (P=.563) or between primiparous versus multiparous women (P=.060). The women whose labour lasted 12hours or less (P=.024), without perineal trauma (P=.021) and those who had not undergone episiotomy (P=.002) achieved a better final CEQ score. Instrumental delivery (forceps) versus normal delivery is associated with lower scores with respect to the final CEQ-E score (P=≤.001).

CONCLUSIONS

Women's overall satisfaction after delivery in HUMIC was high. Instrumental delivery seems to be associated with lower perceived satisfaction. Aspects such as fear and fatigue in labour could affect satisfaction negatively. These aspects can be improved by establishing strategies to increase comfort and minimise pregnant women's fear of labour.

Satisfaction with maternal and birth services: a survey in public hospitals in Turkey

PURPOSE

The purpose of this study was to determine the satisfaction of women who underwent normal delivery and cesarean section (or C-section) with maternal care in five state-run hospitals in Northwestern Turkey.

DESIGN/METHODOLOGY/APPROACH

This was a cross-sectional study. The sample consisted of 580 women who underwent normal delivery (ND) and 392 who had a C-section (CS). Data were collected using two maternal satisfaction questionnaires, which participants completed right before they were discharged.

FINDINGS

More than half of ND (61.7%) and CS (56.9%) participants were satisfied with maternal care. ND participants who had received antenatal training were more satisfied with maternal care than CS participants who had not received antenatal training. Higher income was a significant predictor for reduced satisfaction with maternal care among CS participants (p = 0.031).

PRACTICAL IMPLICATIONS

Hospital administrators and decision-makers should meet women's expectations, provide them with comfort, encourage them for skin-to-skin contact and respect their right to privacy in order to increase their satisfaction with maternal care. Pregnant women should also be encouraged to receive antenatal training offered by hospitals before delivery.

ORIGINALITY/VALUE

The evidence-based results of the study will help hospital administrators to improve healthcare quality and focus on increasing women's satisfaction with maternal care.

Psychometric properties of the Malay version of the Women's Views of Birth Labour Satisfaction Questionnaire using the Rasch measurement model: a cross sectional study

Background

Birth satisfaction represents a complex construct of implicit and profound relevance to a woman’s perceived birth experience. It correlates with the childbearing woman’s experience of the quality of care received and stress during labor. This study aimed to examine the psychometric properties of the Malay language version of the Women’s Views of Birth Labour Satisfaction Questionnaire (WOMBLSQ) on labor satisfaction using the Rasch rating scale model.

Methods

A cross-sectional study was conducted. The translated Malay version of the WOMBLSQ was completed by 200 postpartum women in a tertiary hospital. The Rasch model was applied to investigate the statistics, unidimensionality, item polarity and misfit, person misfit and person item distribution map.

Results

The Rasch analysis showed that the 27 items, in nine dimensions, had high item reliability and item separation at 0.98 and 7.65 respectively, while good person reliability and person separation were at 0.78 and 1.90, respectively. Item 6 (‘My birth partner/husband couldn’t have supported me any better’) (outfit MnSq = 1.74, outfit z-std = 6.9, PtMea Corr = − 0.02) and Item 5 (‘My birth partner/husband helped me to understand what was going on when I was in labor’) (outfit MnSq = 1.65, outfit z-std = 2.9, PtMea Corr = 0.13) are misfit. Item 6 needs to be re-examined for removal or rephrasing, while Item 5 correlates poorly with the construct. Eight persons have the most misfitting response strings based on Item 6 but extremely trivial differences were found in the parameter estimates after refitting the model. Ten items easily endorse satisfaction from the respondents.

Conclusion

The WOMBLSQ tested among postpartum women has been shown to have a good person reliability index and a high item reliability index. Items 5 and 6 do not contribute in the construction of scale but not degrading and suggested for refining. The spread of item difficulty should be improved in the future modification of items.

Primiparous women's experiences of normal vaginal delivery in Iran: a qualitative study

Background

Childbirth is considered as the most challenging psychological event in a woman’s life. It has a major effect on women’s lives with long-term positive or negative impacts. Cultural, religious, and socioeconomic differences can affect women’s perception about normal vaginal delivery (NVD) experience. Therefore, it is necessary to explore the primiparous women’s perception about it.

Methods

This qualitative study, with a descriptive content analysis approach, was conducted in Kashan, a city in the center of Iran. Purposive sampling was used to recruit the participants of the current study. Data was gathered by semi-structured interviews during 24 h after normal vaginal birth among primiparous women. The sampling started from June to October in 2016. Interviews continued until data saturation which was achieved in the 14th interview but for assurance, it continued until the 17th one.

Results

The following three main themes were extracted “immersion in stress”, “pain, the essence of NVD” and “strategies for situation management”. Furthermore, seven subthemes were obtained including ‘loss threat’, ‘stressful context’, temporary impairment in physiologic harmony, paradoxical emotions, self-management, emotional support, and spiritual support.

Conclusions

This study showed that stress and pain were two highlighted issues in NVD process. Increasing women’s awareness about NVD process, familiarizing the primiparous women with the simulated delivery room, accompanying these women for emotional support, and providing spiritual support can be effective in situation management to make the child delivery a pleasant and satisfying experience.

Women's satisfaction with maternity care during preterm birth

BACKGROUND

Women's satisfaction with maternity care is strongly influenced by their sociodemographic characteristics, values, and attitudes. The arrival of a preterm baby is often a traumatic time, with unique factors involved. The Spanish Preterm Birth Experience and Satisfaction Scale (P-BESS) is a robust instrument capable of assessing women's satisfaction during preterm birth. The purpose of this study was to assess women's satisfaction with maternity care during labor and birth with preterm babies in a Spanish-speaking population.

METHODS

This is a cross-sectional study. Participants were 182 women who gave birth within 37 weeks' gestation. Factors associated with satisfaction were studied through univariate and bivariate analyses and through multiple linear regression using the backward elimination method.

RESULTS

Women reported high satisfaction with maternity care overall (average score of 84 out of 95). Women with a university education were generally less satisfied. Women were more satisfied if they were pregnant for the first time. Women who reported a previous premature birth or neonatal death were more satisfied, and women who had prior miscarriages were less satisfied compared with women without these experiences.

CONCLUSIONS

The analysis confirmed that the majority of women surveyed were very satisfied with their childbirth experience. The Spanish P-BESS can be a useful way of prioritizing intervention measures, focusing on those aspects lowest scored by women, such as "information and explanations" and "confidence in staff," to improve maternity services for families experiencing preterm birth.

Adaptation of the Childbirth Experience Questionnaire (CEQ) in China: A multisite cross-sectional study

BACKGROUND

The childbirth experience of women represents a significant aspect of quality care. Due to the lack of a reliable Chinese language tool for assessing childbirth experiences, examples must be adapted from other countries. The aim of this study was to translate an English version of the Childbirth Experience Questionnaire (CEQ) into Chinese and adapt this tool to the Chinese context.

METHODS

A questionnaire validation study was conducted. A forward-backward translation procedure involving the developer of the CEQ was conducted. The data were collected in postnatal wards at 50 birth facilities in 4 regions of Zhejiang Province, China. Women who gave birth vaginally at the investigated facilities during the study period completed an online questionnaire that included the Chinese version of the CEQ (CEQ-C), demographic information and clinical information. Psychometric analyses were performed to assess the internal and content consistency. After subdividing the sample into subsamples, an exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were applied to examine the structural validity. Known-group comparisons were performed to assess the discriminant validity.

RESULTS

Overall, 1747 women participated in this study. The content validity index (CVI) of the CEQ was 0.92. Based on the comments of the experts combined with the statistical results, we removed 3 items related to pain, sense of control and sense of security and changed 3 items to different dimensions. The CFA supported the four dimensions of the CEQ-C (standard root mean square residual (SRMR) = 0.037, root mean square error of approximation (RMSEA) = 0.036, comparative fit index (CFI) = 0.966, and Tucker-Lewis index (TLI) = 0.959). Cronbach's alpha of the CEQ-C was 0.88, and McDonald's omega value was 0.91. The duration of labor, delivery mode, parity, oxytocin augmentation, pain management, companionship, prenatal education and pain experienced exerted significant effects on the women's childbirth experiences.

CONCLUSIONS

Although some items performed differently in our analysis comparing the English and Chinese versions of the CEQ, the CEQ-C is reliable and valid. Additionally, the CEQ-C is an easy-to-use and promising tool for measuring childbirth experiences among Chinese women in facility settings that can be used to improve the quality of intrapartum care. Efforts are needed to provide women with respectful, evidence-based intrapartum care to facilitate positive childbirth experiences.

Women's perception of support and control during childbirth in The Gambia, a quantitative study on dignified facility-based intrapartum care

Background

In The Gambia, a woman faces 1 in 24-lifetime risk of maternal death due to pregnancy and childbirth, yet, only 57% of deliveries are conducted by skilled birth attendants. However, poor provider attitude has been identified as one of the contributing factors hampering the efforts of the government in improving access to skilled care during childbirth. This study, therefore, explored women’s perception of support and control during childbirth in The Gambia.

Methods

A descriptive cross-sectional study was employed. A convenience sampling method was used to select participants in two regions in The Gambia. A sample size of 200 women who met the eligibility criteria was recruited after informed consent. The demographic-obstetric information sheet and the Support and Control in Birth scale (SCIB) were used to collect data. Data analysis was done using SPSS software version 23.0.

Results

Women’s perceptions of support and control were low. External control 1.85 (SD ± 0.43) recorded the least perception compared to internal control 2.41 (SD ± 0.65) and perception of support 2.52 (SD ± 0.61). Participants reported the lowest perceptions in pain control, involvement in decision making, information sharing and the utilization of different position during birth. Women’s age (p < .001) and mode of delivery (p = .01), significantly predicted women’s perception of internal control. Educational status (p = .02), mode of delivery (p = .04), place of delivery (p < .001) and perception of support (p < .001) significantly predicted women’s perception of external control, whilst birth plan (p = .001), mode of delivery (p = .04), and perception of external control (p < .001) significantly predicted women’s perception of support.

Conclusion

This study concluded that an environment that promotes women feeling a sense of control and support during childbirth should be created in order to ensure a dignified intrapartum care in The Gambia. This can be achieved through effective training of skilled birth attendants on non-pharmacological pain management, effective communication with clients and promoting women’s participation in decision-making regarding their care throughout the process of childbirth.

Electronic supplementary material

The online version of this article (10.1186/s12884-018-2025-5) contains supplementary material, which is available to authorized users.

Maternal Satisfaction on Delivery Service among Postnatal Mothers in a Government Hospital, Mid-Western Nepal

Background

Maternal satisfaction is one of the most frequently reported outcome measures for quality of care, and it needs to be addressed to improve the quality and efficiency of health care during pregnancy, childbirth, and puerperium to provide quality maternal-friendly services.

Objective

To find out the maternal satisfaction on delivery service among postnatal mothers in a government hospital, Mid-Western Nepal.

Method

A descriptive, cross-sectional study was conducted in maternity ward of Bheri Zonal Hospital, Nepal. A total of 178 purposively selected postnatal mothers were interviewed face-to-face using semistructured interview schedules. Analysis and interpretation of the findings were done with the help of descriptive and inferential statistics.

Results

The study shows that majority (89.88%) of the mothers were satisfied with the delivery service. The level of satisfaction was higher in interpersonal and technical aspects (93.82%) of care than in informative aspects (91.57%) and health facility-related statements (91.01%). There was no statistically significant association between sociodemographic and obstetric characteristics and maternal satisfaction. Although insignificant, postnatal mothers who were illiterate were 2.710 times more likely to be satisfied than who were literate (p=0.475; OR = 2.710; CI = 0.343-21.4), also postnatal mothers up to primary level were 2.850 times more likely to be satisfied than secondary level and above (p=0.241; OR-2.850; CI 0.622-13.056). Also, in this study, postnatal mothers who were multiparous were 2.352 times more likely to be satisfied with the delivery service than primiparous (p=0.111; OR = 2.352; CI = 0.801-6.907). Majority (87.1%) of the mothers would like to receive delivery service next time in the same hospital.

Conclusion

Majority of mothers were satisfied by the delivery service. Care givers need to fully understand the expectations the mothers have and provide care that is consistent with those expectations. The health system should be devised to increase maternal satisfaction in the health institution and provide maternal-friendly service.

Continuity of care is an important and distinct aspect of childbirth experience: findings of a survey evaluating experienced continuity of care, experienced quality of care and women's perception of labor

Background

To compare experienced continuity of care among women who received midwife-led versus obstetrician-led care. Secondly, to compare experienced continuity of care with a. experienced quality of care during labor and b. perception of labor.

Methods

We conducted a questionnaire survey in a region in the Netherlands in 2014 among 790 women after they gave birth. To measure experienced continuity of care, the Nijmegen Continuity Questionnaire was used. Quality of care during labor was measured with the Pregnancy and Childbirth Questionnaire, and to measure perception of labor we used the Childbirth Perception Scale.

Results

Three hundred twenty five women consented to participate (41%). Of these, 187 women completed the relevant questions in the online questionnaire. 136 (73%) women were in midwife-led care at the onset of labor, 15 (8%) were in obstetrician-led care throughout pregnancy and 36 (19%) were referred to obstetrician-led care during pregnancy. Experienced personal and team continuity of care during pregnancy were higher for women in midwife-led care compared to those in obstetrician-led care at the onset of labor. Experienced continuity of care was moderately correlated with experienced quality of care although not significantly so in all subgroups. A weak negative correlation was found between experienced personal continuity of care by the midwife and perception of labor.

Conclusion

This study suggests that experienced continuity of care depends on the care context and is significantly higher for women who are in midwife-led compared to obstetrician-led care during labor. It will be a challenge to maintain the high level of experienced continuity of care in an integrated maternity care system.

Experienced continuity of care seems to be a distinctive concept that should not be confused with experienced quality of care or perception of labor and should be considered as a complementary aspect of quality of care.

Electronic supplementary material

The online version of this article (10.1186/s12884-017-1615-y) contains supplementary material, which is available to authorized users.

A Qualitative Study on Women's Experiences of Intrapartum Nursing Care at Tamale Teaching Hospital (TTH), Ghana

Introduction: Labor and delivery process is an exciting, anxiety-provoking, but rewarding time for a woman and her family after successful delivery of a newborn. The intrapartum period is the time where mothers expect more care. Taking care of a mother through delivery with no side effects is the task of a professional midwife who is trained with the skill to take the responsibility of caring for mothers and babies. Therefore, the aim of this study was to explore mother's experiences regarding quality of intrapartum nursing/midwifery care. Methods: Focused ethnographic study was employed. Data were collected from May to June 2016 TTH, Ghana using semi structured interview guide. Purposive sampling was employed to recruit 20 participants. Eight individual interviews were conducted in the post natal ward after 48 hours of delivery, followed by three focus group discussions two weeks after delivery when mothers visited post natal clinic. Interviews lasted for about 30-45 minutes during each session. Data were analyzed using thematic analysis. Results: The average age of women were 29 years with ranging from 19-43 years. Participants' experiences of nursing/midwifery care during birth were influenced by reception and respect, provision of information, technical skill, providers' behavior, pain management and availability of nurses/midwives. Conclusion: The study findings have revealed that women's experience of care is affected by a wide range of determinants. Therefore, maternal health programs and policies in Ghana must take into account women's perspective on the care they need and their feedback on services they receive. Nursing education should re-enforce communication/relational skills.

Measuring women's childbirth experiences: a systematic review for identification and analysis of validated instruments

BACKGROUND

Women's childbirth experience can have immediate as well as long-term positive or negative effects on their life, well-being and health. When evaluating and drawing conclusions from research results, women's experiences of childbirth should be one aspect to consider. Researchers and clinicians need help in finding and selecting the most suitable instrument for their purpose. The aim of this study was therefore to systematically identify and present validated instruments measuring women's childbirth experience.

METHODS

A systematic review was conducted in January 2016 with a comprehensive search in the bibliographic databases PubMed, CINAHL, Scopus, The Cochrane Library and PsycINFO. Included instruments measured women's childbirth experiences. Papers were assessed independently by two reviewers for inclusion, and quality assessment of included instruments was made by two reviewers independently and in pairs using Terwee et al's criteria for evaluation of psychometric properties.

RESULTS

In total 5189 citations were screened, of which 5106 were excluded by title and abstract. Eighty-three full-text papers were reviewed, and 37 papers were excluded, resulting in 46 included papers representing 36 instruments. These instruments demonstrated a wide range in purpose and content as well as in the quality of psychometric properties.

CONCLUSIONS

This systematic review provides an overview of existing instruments measuring women's childbirth experiences and can support researchers to identify appropriate instruments to be used, and maybe adapted, in their specific contexts and research purpose.

Snoezelen Room and Childbirth Outcome: A Randomized Clinical Trial

Background:

One of the strategies for a good outcome and pain free childbearing is to design the delivery room.

Objectives:

The aim of this study was to evaluate the effects of snoezelen room on childbearing outcome such as pain intensity, duration of labor, and perinea status in nulliparous women.

Patients and Methods:

This study was a randomized controlled clinical trial consists of 100 childbearing women. They were randomly divided into 2 groups. The experimental group went to snoezelen room when their cervix dilation was 4 cm, while the control group went to physiologic delivery room with the same cervix dilation.

Results:

The mean ± SD of VAS (Visual Analogue Scale) pain intensity of the experimental and control groups before the intervention were 5.1 ± 1.95 and 5.58 ± 1.62, respectively (P = 0.13). The mean ± SD of VAS pain intensity scores of the experimental and control groups after 3 hours spending in their assigned rooms were 5.26 ± 0.86 and 9.56 ± 1.48, respectively (P = 0.01). The mean ± SD of the first stage scores of the experimental and control groups were 6.95 ± 0.97 and 8.41 ± 0.67, respectively (P = 0.042). About 92% of participants’ intervention vs. 66% of control participants had perinea laceration (P = 0.041).

Conclusions:

According to the findings of the present study, distracting senses in snoezelen room decreases mother’s pain intensity, the length of labor, and incidence of episiotomy.

Jordanian women's dissatisfaction with childbirth care

BACKGROUND

Dissatisfaction with childbirth care can have a negative impact on a woman's health and well-being, as well as her relationships with her infant.

AIM

To investigate the prevalence and associated factors of dissatisfaction with intrapartum care by Jordanian women.

METHOD

A descriptive cross-sectional study was used. Participants (n = 320) who were 7 weeks post-partum were recruited from five maternal and child health centres in Irbid city in northern Jordan. Participants provided personal and obstetric information, and completed the Satisfaction with Childbirth Care Scale.

RESULTS

The majority of women (75.6%) were dissatisfied with their intrapartum care. Dissatisfaction was associated with the attendance of unknown and unwanted persons during childbirth, experiencing labour as more painful than expected, and perceptions of inadequate help from healthcare providers to manage pain during labour.

LIMITATIONS

Findings are limited to Jordanian women accessing public sector perinatal health services.

CONCLUSION

The high percentage of women reporting dissatisfaction with intrapartum care in this study is of concern. Women's perception of pain and expectations of staff during labour and birth need to be addressed through education and improved communication by staff.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Development of national evidence-based policies and quality assurance systems would help reduce the rate of obstetric interventions and give greater emphasis to respect for women's preferences during labour and birth.

A Rasch-based dimension of delivery experience: spontaneous vs. medically assisted conception

AIMS AND OBJECTIVES

To devise a set of indices representative of a latent dimension of delivery perception, aimed at the assessment of birth experience after both spontaneous and medically assisted conception.

BACKGROUND

Birth experience is of great importance for its prognostic value for the woman and newborn's psychophysical well-being, especially after the experience of assisted reproduction technology. Up to date, a delivery perception assessment measure targeted to both spontaneously and medically assisted conceiving women does not exist yet.

DESIGN

Measure development and psychometric analysis; quantitative and qualitative analysis of women's delivery experience measures.

METHODS

Thirty-one indices characterising seven relevant aspects of birth perception were devised from the literature and evaluated on a 4-point Likert-type scale by 98 childbearing women (54 spontaneously and 44 medically assisted conceiving) in the 24-48 hours postpartum time frame. Women's obstetric history information was also collected. The dimension psychometric definition was pursued within a latent trait perspective, by applying the many-facet Rasch measurement model.

RESULTS

A latent delivery perception dimension composed of 18 valid and reliable indices, qualifying six labour and delivery perception clinical aspects, was identified. Medically assisted conceiving women evidenced a more positive birth perception, but when analysing each index, they showed peculiar intense worries about themselves and their baby's health, even if they felt more satisfied, safer and stronger in almost every labour and birth aspect.

CONCLUSIONS

The delivery perception dimension integrates all relevant birth experience aspects in 18 easy-to-administer indices and provides a valid, reliable and feasible assessment tool for both the clinical practice and research purposes.

RELEVANCE TO CLINICAL PRACTICE

The delivery perception dimension clearly discriminates between women's types of conception and identifies relevant differences in their birth experience, which are interesting for their clinical implications within a prognostic and intervention perspective of support provision in the early postpartum period.