A simple tool to measure patient perceptions of operative birth

Abstract

Objective To assess the feasibility and validity of a maternal satisfaction measurement tool, the SaFE study Patient Perception Score (PPS), after operative delivery.Design Cross-sectional survey.Setting A large maternity unit in England.Sample 150 women who had had an operative birth.Methods We recruited women within 24 hours of birth and quantified their satisfaction with two questionnaires: PPS, and the Mackey Childbirth Satisfaction Rating Scale (CSRS; modified).Main Outcome Measures Participation rate to determine feasibility; Cronbach's alpha as measure of internal consistency; PPS satisfaction scores for groups of accoucheurs of different seniority to assess construct validity; correlation coefficient of PPS scores with total scores from the CSRS questionnaire to establish criterion validity.Results Participation rate approached 85%. We observed high scores for most births except a few outliers. Internal consistency of the PPS was high (Cronbach's alpha = 0.83). Total PPS scores correlated strongly with total CSRS scores (Spearman's r = 0.64, P < 0.001).Conclusions The PPS is a simple and valid tool for patientcentred assessments. High scores were observed for most births but there were a small minority of accoucheurs who consistently scored poorly and these data could be used during appraisal and training.

Satisfaction with childbirth services provided in public health facilities: results from a cross- sectional survey among postnatal women in Chhattisgarh, India

“…A woman’s obstetric history, mode of childbirth, and her feelings towards recent childbirth can also affect childbirth satisfaction. For example: being multiparous, preferring a spontaneous vaginal birth and being able to have a spontaneous vaginal birth [15,28] enhances the women’s satisfaction with giving birth. The feelings associated with childbirth itself, due to limited opportunities of exploration in quantitative studies, pose some confounders like the ‘halo effect’ – a positive attitude prevailing due to successfully giving birth – making it difficult to separate childbirth satisfaction from satisfaction with childbirth services [12,29,30].…”

Quality improvement demands quality measurement

“…A number of national reviews have been completed, with variable results. 8,9 A simple three-part patient perception score has recently been validated for use after instrumental delivery, 10 and this may be sufficiently user-friendly for regular feedback.…”

Vivência do parto normal ou cesáreo: revisão integrativa sobre a percepção de mulheres

“…Hospitalization becomes an essentially modern life experience, offering specialized technical assistance; the hospital is the safest place to have a child, but it is also the worst place when it comes to the care received by many women and the loss of their autonomy. 19,21 Nevertheless, in a Brazilian study, women identified the doctor as the only professional trained to take care of them during vaginal birth; 21 however, it is important to note that in two international studies conducted in England and Jordan, [25][26] women reported greater satisfaction with the care received when assisted by obstetrical nurses and midwives. [25][26] Recommendations for obstetric care in vaginal birth and caesarean section…”

“…Just like the compliance with the provisions governing the universal rights of man and the principles of the Single Health System, investments towards improving the quality of care in labor and delivery are necessary, as well as the actual implementation of the Program for Humanization of Prenatal Care and Birth in Brazil. [15][16]19,21,26 They also indicated that it is essential to plan and implement appropriate strategies that can help women experience childbirth with lower levels of fear and anxiety, using coping mechanisms to reduce the levels of pain and help them regain a sense of control during childbirth. 25 The importance of the relationship between health professionals and pregnant women has also been highlighted.…”

“…20 In two studies, high levels of satisfaction were reported by mothers who experienced cesarean section. 20,26 Positive factors regarding cesarean delivery were identified by women who have experienced this type of delivery in the past and chose to have it again. 23 They described as positive aspects of this choice that cesarean delivery is easier and faster, the surgical incision is performed on top of the already existing scar, they can set the date, there is greater control and safety for the baby, they avoid the fear of childbirth and induction, they already know what to expect of the procedure, they avoid the trauma of a new emergency cesarean section and recovery is relatively easy.…”