Evaluation of satisfaction with care in a midwifery unit and an obstetric unit: a randomized controlled trial of low-risk women

Stine Bernitz, Pål Øian, Leiv Sandvik, Ellen Blix, Stine Bernitz, Pål Øian, Leiv Sandvik, Ellen Blix

Abstract

Background: Satisfaction with birth care is part of quality assessment of care. The aim of this study was to investigate possible differences in satisfaction with intrapartum care among low-risk women, randomized to a midwifery unit or to an obstetric unit within the same hospital.

Methods: Randomized controlled trial conducted at the Department of Obstetrics and Gynecology, Østfold Hospital Trust, Norway. A total of 485 women with no expressed preference for level of birth care, assessed to be at low-risk at onset of spontaneous labor were included. To assess the overall satisfaction with intrapartum care, the Labour and Delivery Satisfaction Index (LADSI) questionnaire, was sent to the participants 6 months after birth. To assess women's experience with intrapartum transfer, four additional items were added. In addition, we tested the effects of the following aspects on satisfaction; obstetrician involved, intrapartum transfer from the midwifery unit to the obstetric unit during labor, mode of delivery and epidural analgesia.

Results: Women randomized to the midwifery unit were significantly more satisfied with intrapartum care than those randomized to the obstetric unit (183 versus 176 of maximum 204 scoring points, mean difference 7.2, p = 0.002). No difference was found between the units for women who had an obstetrician involved during labor or delivery and who answered four additional questions on this aspect (mean item score 4.0 at the midwifery unit vs 4.3 at the obstetric unit, p = 0.3). Intrapartum transfer from the midwifery unit to an obstetric unit, operative delivery and epidurals influenced the level of overall satisfaction in a negative direction regardless of allocated unit (p < 0.001).

Conclusion: Low-risk women with no expressed preference for level of birth care were more satisfied if allocated to the midwifery unit compared to the obstetric unit.

Trial registration: The trial is registered at www.clinicaltrials.gov NCT00857129 . Initially released 03/05/2009.

Keywords: Birth care unit; Intrapartum care; Low-risk birth; Satisfaction.

Figures

Fig. 1
Fig. 1
Flowchart of inclusion

References

    1. Hodnett ED, Downe S, Walsh D. Alternative versus conventional institutional settings for birth. Cochrane Database Syst Rev. 2012;8:CD000012.
    1. Birthplace in England Collaborative G Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ (Clinical research ed) 2011;343:d7400. doi: 10.1136/bmj.d7400.
    1. Gottvall K, Waldenstrom U, Tingstig C, Grunewald C. In-hospital birth center with the same medical guidelines as standard care: a comparative study of obstetric interventions and outcomes. Birth (Berkeley, Calif) 2011;38(2):120–128. doi: 10.1111/j.1523-536X.2010.00461.x.
    1. Homer CS, Friberg IK, Dias MA, ten Hoope-Bender P, Sandall J, Speciale AM, Bartlett LA. The projected effect of scaling up midwifery. Lancet. 2014;384(9948):1146–1157. doi: 10.1016/S0140-6736(14)60790-X.
    1. Eide BI, Nilsen AB, Rasmussen S. Births in two different units in the same clinic-Aprospective study of healthy primiparous women. BMC Pregnancy Childbirth. 2009;9:25. doi: 10.1186/1471-2393-9-25.
    1. Bernitz S, Aas E, Oian P. Economic evaluation of birth care in low-risk women. A comparison between a midwife-led birth unit and a standard obstetric unit within the same hospital in Norway. A randomised controlled trial. Midwifery. 2012;28(5):591–599. doi: 10.1016/j.midw.2012.06.001.
    1. Schroeder E, Petrou S, Patel N, Hollowell J, Puddicombe D, Redshaw M, Brocklehurst P, on behalf of the Birthplace in England Collaborative G Cost effectiveness of alternative planned places of birth in woman at low risk of complications: evidence from the Birthplace in England national prospective cohort study. BMJ (Clinical research ed) 2012;344:e2292.
    1. National Institute of Health and Care Excellence. Intrapartum care. Care of healthy women and their babies during childbirth. Oxford: National Collaborating Centre for Women's and Children's Health; 2014.
    1. Byrne JP, Crowther CA, Moss JR. A randomised controlled trial comparing birthing centre care with delivery suite care in Adelaide, Australia. Aust N Z J Obstet Gynaecol. 2000;40(3):268–274. doi: 10.1111/j.1479-828X.2000.tb03333.x.
    1. Chapman MG, Jones M, Spring JE, De Swiet M, Chamberlain GV. The use of a birthroom: a randomized controlled trial comparing delivery with that in the labour ward. Br J Obstet Gynaecol. 1986;93(2):182–187. doi: 10.1111/j.1471-0528.1986.tb07884.x.
    1. Hundley VA, Cruickshank FM, Lang GD, Glazener CM, Milne JM, Turner M, Blyth D, Mollison J, Donaldson C. Midwife managed delivery unit: a randomised controlled comparison with consultant led care. BMJ (Clinical research ed) 1994;309(6966):1400–1404. doi: 10.1136/bmj.309.6966.1400.
    1. MacVicar J, Dobbie G, Owen-Johnstone L, Jagger C, Hopkins M, Kennedy J. Simulated home delivery in hospital: a randomised controlled trial. Br J Obstet Gynaecol. 1993;100(4):316–323. doi: 10.1111/j.1471-0528.1993.tb12972.x.
    1. Waldenstrom U, Nilsson CA. Women’s satisfaction with birth center care: a randomized, controlled study. Birth (Berkeley, Calif) 1993;20(1):3–13. doi: 10.1111/j.1523-536X.1993.tb00173.x.
    1. Tingstig C, Gottvall K, Grunewald C, Waldenstrom U. Satisfaction with a modified form of in-hospital birth center care compared with standard maternity care. Birth (Berkeley, Calif) 2012;39(2):106–114. doi: 10.1111/j.1523-536X.2012.00533.x.
    1. Goberna-Tricas J, Banus-Gimenez MR, Palacio-Tauste A, Linares-Sancho S. Satisfaction with pregnancy and birth services: the quality of maternity care services as experienced by women. Midwifery. 2011;27(6):e231–e237. doi: 10.1016/j.midw.2010.10.004.
    1. Melender HL. What constitutes a good childbirth? A qualitative study of pregnant Finnish women. J Midwifery Womens Health. 2006;51(5):331–339. doi: 10.1016/j.jmwh.2006.02.009.
    1. Britton JR. The assessment of satisfaction with care in the perinatal period. J Psychosom Obstet Gynaecol. 2012;33(2):37–44. doi: 10.3109/0167482X.2012.658464.
    1. Brown S, Lumley J. Satisfaction with care in labor and birth: a survey of 790 Australian women. Birth (Berkeley, Calif) 1994;21(1):4–13. doi: 10.1111/j.1523-536X.1994.tb00909.x.
    1. Hodnett ED. Pain and women’s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol. 2002;186(5 Suppl Nature):S160–S172.
    1. Waldenstrom U, Rudman A, Hildingsson I. Intrapartum and postpartum care in Sweden: women’s opinions and risk factors for not being satisfied. Acta Obstet Gynecol Scand. 2006;85(5):551–560. doi: 10.1080/00016340500345378.
    1. Britton C,McCormick FM, Renfrew MJ,Wade A, King SE. Support for breastfeedingmothers. Cochrane Database Syst Rev. 2007;(1):CD001141. doi:10.1002/14651858.CD001141.pub3.
    1. Biro MA, Waldenstrom U, Brown S, Pannifex JH. Satisfaction with team midwifery care for low- and high-risk women: a randomized controlled trial. Birth. 2003;30(1):1–10. doi: 10.1046/j.1523-536X.2003.00211.x.
    1. Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev. 2013;8:CD004667.
    1. Waldenstrom U, Brown S, McLachlan H, Forster D, Brennecke S. Does team midwife care increase satisfaction with antenatal, intrapartum, and postpartum care? A randomized controlled trial. Birth. 2000;27(3):156–167. doi: 10.1046/j.1523-536x.2000.00156.x.
    1. Bernitz S, Rolland R, Blix E, Jacobsen M, Sjoborg K, Oian P. Is the operative delivery rate in low-risk women dependent on the level of birth care? A randomised controlled trial. BJOG. 2011;118(11):1357–1364. doi: 10.1111/j.1471-0528.2011.03043.x.
    1. Lomas J, Dore S, Enkin M, Mitchell A. The Labor and Delivery Satisfaction Index: the development and evaluation of a soft outcome measure. Birth (Berkeley, Calif) 1987;14(3):125–129. doi: 10.1111/j.1523-536X.1987.tb01472.x.
    1. Sawyer A, Ayers S, Abbott J, Gyte G, Rabe H, Duley L. Measures of satisfaction with care during labour and birth: a comparative review. BMC Pregnancy Childbirth. 2013;13:108. doi: 10.1186/1471-2393-13-108.
    1. Harvey S, Rach D, Stainton MC, Jarrell J, Brant R. Evaluation of satisfaction with midwifery care. Midwifery. 2002;18(4):260–267. doi: 10.1054/midw.2002.0317.
    1. Carpenter RJ, Kenward GM. Missing data in randomised controlled trials - a practical guide. 2007. Available at: . Accessed Oct 2014.
    1. Waldenstrom U, Hildingsson I, Rubertsson C, Radestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004;31(1):17–27. doi: 10.1111/j.0730-7659.2004.0270.x.
    1. Spaich S, Welzel G, Berlit S, Temerinac D, Tuschy B, Sutterlin M, Kehl S. Mode of delivery and its influence on women’s satisfaction with childbirth. Eur J Obstet Gynecol Reprod Biol. 2013;170(2):401–406. doi: 10.1016/j.ejogrb.2013.07.040.
    1. Anim-Somuah M, Smyth RM, Jones L. Epidural versus non-epidural or no analgesia in labour. Cochrane Database Syst Rev. 2011;12:CD000331.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다