Elsevier

Women and Birth

Volume 20, Issue 3, September 2007, Pages 115-120
Women and Birth

Women's expectations of maternity services: A community-based survey

https://doi.org/10.1016/j.wombi.2007.05.003Get rights and content

Summary

Background

Examining women's preferences for maternity care is overdue. Understanding women's preferences and re-orienting services to meet their expectations is critical to improving health outcomes.

Method

A self-report survey of a convenience community sample of 63 women visiting a Maternity Coalition/Association for Improvements in Maternity Services stall at a Mother and Baby Expo in 2003.

Results

Over 95% of women ranked birth safety, bonding with the baby, feeling in control during birth, and postnatal care as “very important”. Over 85% of women rated educational preparation for birth, the relationship with their caregiver, prenatal care, and breastfeeding successfully as “very important”. Avoiding labour pain was considered less important by more women than any other item. Around half the respondents preferred their birth care to be from a chosen midwife with access to medical backup (57.9%, n = 37). Some women identified a lack of choice of care options with 45.9% (n = 17) reporting “little” or “no” choice in birth care for their previous birth. Poor quality care was also identified with 57.9% (n = 22) rating their postnatal care as “mediocre”. Given assurance of equal safety and free care, 50% (n = 31) of participants would prefer to give birth at a birth centre and 24.2% (15 out of 63) would prefer a homebirth.

Conclusion

Factors associated with safety, control, continuity of care and successful mothering are perceived as important for many women. Some women perceived limited birth choices. More needs be done to align the provision of maternity services with women's preferred care options. Given the small self-select, non-representative sample, results should be interpreted with caution.

Section snippets

Background

Few birthing options are available to Queensland women. Up until 2006 there were only two small birth centres which provided care to 457 women a year; representing 0.9% of the 50,777 births per annum.1 Demand for birth centre care exceeds supply by as much as 3:1 despite no advertising and numerous access barriers. Standard maternity care is medicalised with a 32% caesarean section rate2 and fragmented service delivery.3 The provision and organisation of maternity services has largely been

Method

A short, self-report survey distributed to a convenience sample of Queensland women.

Results

Sixty-three women completed the survey. Twenty-four women (38.1%) had not borne any children, 23 (36.5%) had given birth to one child and 16 (25.4%) had given birth to more than one child. Parity for the sample is shown in Table 1. Most parous women reported that they had given birth in hospital (79.5%, n = 31) while the remaining women in this group (20.5%, n = 8) had attended a Birth Centre. No women reported giving birth at home. There were no statistically significant differences in responses

Discussion

This small survey confirmed that women are concerned about safety for their baby and seek control and participation in decision making during birth. This finding is consistent with other studies.3, 6 Other studies have also demonstrated that most women value maternity care including educational preparation for birth, and want to breastfeed successfully.18, 19 Similarly, many women reported a lack of choice in birth care and poor quality postpartum care.3

Avoiding pain in labour was rated as

Conclusions

Few studies have investigated the extent to which maternity services are focussed on women's needs. The results of this small exploratory study with a self-select, non-representative sample should be interpreted with caution however, it has identified that women are concerned about safety for their baby and seek control and participation in decision making during birth, but may be misinformed about the risks and benefits of various options. When assured of safety, preferences for the place of

Acknowledgements

Thank you to the Home Midwifery Association, Maternity Coalition, and Association for Improvement of Maternity Services for distributing the survey. Thank you also to Dr. Sarah Buckley for help developing the questionnaire. There has been no financial assistance associated with this project.

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