Paper
Thursday, July 22, 2004
What Constitutes Quality? Women's Experiences of Maternity Services
Annie E. Topping, PhD, BSc, RGN, School of Health Studies, University of Bradford, Bradford, West Yorkshire, United Kingdom and Lesley Lockyer, PhD, MSc, BSc, RGN, Faculty of Health and Social Work, University of the West of England, Bristol, AVON, United Kingdom.
| Learning Objective #1: Appreciate the complexity associated with measuring women's satisfaction with maternity care |
| Learning Objective #2: Consider the impact on women of successful midwife-led strategies to promote breast-feeding uptake and subsequent early cessation |
Background: Much of recent United Kingdom government policy has emphasised the need for health care providers to engage with consumers in order that health services meet the needs of the communities they serve. A North of England acute National Health Service (NHS) Trust secured funding through a private finance initiative (PFI) to re-build existing maternity facilities. Previously most women booked and delivered under the care of an obstetrician with only a small proportion experiencing hospital based midwife led care or home birth. The new facilities were designed to provide a modern built environment and enabled all aspects of care -labour, delivery, recovery and post natal (LDRP) provision to be delivered in a single room. Objective: To evaluate the impact of the introduction of LDRP facilities on maternal satisfaction with care. Design: A pre and post test postal survey of maternal satisfaction with care was undertaken using the Women's Experience of Maternity Services (SWEMS-Short Form) instrument designed by Lamping and Rowe (1996). Population: All women with live babies 12 weeks post-delivery (Phase I: n=596; Phase II: n=525) over two three month periods were invited to participate. Sample: Phase I: n=400, response rate 67%; Phase II: n=362, response rate 69%. Findings: The results at both time points indicate women were largely satisfied with the maternity care they received and significantly more satisfied with information received in Phase II. Breast feeding uptake was higher immediately post-delivery but cessation rapidly increased with low compliance at 3 months. Conclusions: Comparison of the Phase I and II results suggests LDRP care delivery was well received by women. Compliance with breast feeding initiatives may be difficult to sustain on discharge home. Implications: Satisfaction and breast feeding should be contextualised to contemporary policy drivers and rhetorics associated with women's choice.
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Sigma Theta Tau International
July 22-24, 2004