Women's perceptions of informed choice in maternity care.
ABSTRACT to describe the extent to which women using maternity services perceive that they have exercised informed choice.
twelve maternity units in Wales.
postal survey of women using maternity services, covering women's views of the extent to which they exercised informed choice overall, and at eight decision points during their care.
1386 women at approximately 28 weeks gestation (antenatal sample) and 1741 women at approximately 8 weeks post delivery (postnatal sample).
54% of women perceived that they exercised informed choice overall in the antenatal sample (95% CI: 51-57%) and 54% overall in the postnatal sample (95% CI: 52-56%). Perceptions of informed choice differed by decision point, varying between 31% for fetal heart monitoring during labour and 73% for the screening test for Down's syndrome and spina bifida in the baby. There were differences by maternity unit, even when the characteristics of women attending these units were taken into account. Multiparous women, women from manual occupations and women with lower educational status were more likely to feel that they exercised informed choice during antenatal care. These sub-groups of women were also more likely to report a preference for not sharing decision-making with health professionals.
a large minority of women felt that they had not exercised informed choice overall in their maternity care. The perception of informed choice differed by decision point, maternity unit and characteristics of the woman.
attaining informed choice is more of a challenge for some decision points in maternity care than others, particularly fetal monitoring. The difference in levels of informed choice between maternity units highlights the importance of maternity unit policy in the promotion of informed choice.
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ABSTRACT: AimsWe investigated the involvement of first-time mothers, who had a planned Caesarean section, in the decision to have a Caesarean section, taking into account their different educational levels. Subjects and methodsA self-assessment questionnaire was sent in July 2005 to women who had undergone a Caesarean section in 2004. Participants were 2,685 members of a statutory health insurance fund who had given birth by Caesarean section (response rate: 48.0%). Included were primiparae with planned Caesarean section (n = 352). ResultsThe women in this cross-sectional study felt well informed about the procedure of a section but not its consequences. They used several sources of information and were most satisfied with the information provided by doctors and midwives. Of the women in this study 20% did not have a midwife. No major differences were observed between different educational levels. ConclusionAlthough most women were satisfied with their decision, they felt that they did not receive enough information about the consequences of a Caesarean section. This information need could be met by a further involvement of midwives in maternity care.Journal of Public Health 08/2009; 17(4):273-280. DOI:10.1007/s10389-008-0246-1 · 2.06 Impact Factor
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ABSTRACT: IntroductionTransparent and effective quality management is an essential marketing tool for maternity clinics. Procedures for quality assurance in maternity clinics differ from those in other medical professions. Apart from evidence-based health care the pregnant woman's choice of maternity services providers is increasingly influenced by a number of other factors as well, such as, for example, the response to individual needs or the staff. Hence, the facilities need to present their services and quality of care according to the needs of the target group.Methods In order to identify these needs, a survey was performed among 152 pregnant women during the “Baby Fair”, which took place in Berlin in 2006. The objective of the survey was to find out about the preferences and expectations of pregnant women towards the maternity clinic and breastfeeding and their current criteria for the choice of a maternity clinic. The questionnaire contained questions about expectations towards the maternity clinic staff, traditional medicine and alternative medicine, premises, courses offered, rooming-in and expectations towards breastfeeding.ResultsThe findings from the survey show that the pregnant women's ratings for personal contact, expertise and kindness of the staff were twice as high as for premises, comfort and service. The provision of traditional versus alternative medicine was rated equally. More than 90% of the respondents do see a demand for specific public relations campaigns by maternity clinics concerning information about the particular institution, its range of activities and the impact and process of rooming-in. Only 20% of the respondents felt sufficiently informed about breastfeeding.Conclusion Besides medical and technical factors, staff factors play a key role in the assessment of maternity clinics. In addition to evidence-based medical information communication strategies should also include information on the staff employed. In particular, information is lacking on rooming-in and breastfeeding, which emphasises the necessity for the timely provision of scientifically based information to pregnant women.Zeitschrift für Evidenz Fortbildung und Qualität im Gesundheitswesen 01/2008; 102(7):431-439. DOI:10.1016/j.zgesun.2008.01.003