Birthgiving women's feelings and perceptions of quality of intrapartal care: a nationwide Swedish cross-sectional study

Abstract

Aim: The aim was to explore the relationships between the feelings of women who give birth and several birth-related care conditions, the womens' socio-demographic background, personality and perceptions of the quality of intrapartum care.

Background: Childbirth is a highly significant emotional event for women and it is an explicit goal that each woman should have a positive childbirth experience.

Design: The nationwide study is cross-sectional and was conducted at Swedish maternity units over two months in 2007.

Methods: The study group consisted of 739 women (63% response rate). A dimensionality analysis of six emotion items was performed using structural equation modelling (SEM). Non-parametric tests and generalised linear mixed effects model analyses were used to study relationships and to make subgroup comparisons.

Results: In the SEM analysis, a positive and a negative feeling factor were identified. Strong associations between the feeling factors and the womens' perceptions of the quality of care were found, particularly in regard to the so-called identity-oriented approach of the midwives and other health professionals. In addition, a higher intensity of negative feelings was associated with a personality pattern characterised by extraversion, emotional instability and lower degree of conscientiousness, a lower level of education and having had delivery through Caesarean section.

Conclusions: The positive and negative feelings of women who give birth strongly covary with the women's perception of the quality of their intrapartum care. This pertains in particular to information issues, the midwives showing commitment, empathy and respect, being present during labour and allowing the women to actively participate as much as they want to.

Relevance to clinical practice: Subgroup differences indicate that midwives should pay increased attention to childbearing women who have primary school education only, a lower emotional stability and/or deliver through Caesarean section.