Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2015

Open Access 01-12-2015 | Research article

The quality of childbirth care in China: women’s voices: a qualitative study

Authors: Joanna Raven, Nynke van den Broek, Fangbiao Tao, Huang Kun, Rachel Tolhurst

Published in: BMC Pregnancy and Childbirth | Issue 1/2015

Login to get access

Abstract

Background

In the context of improved utilisation of health care and outcomes, rapid socio-economic development and health system reform in China, it is timely to consider the quality of services. Data on quality of maternal health care as experienced by women is limited. This study explores women’s expectations and experiences of the quality of childbirth care in rural China.

Methods

Thirty five semi-structured interviews and five focus group discussions were conducted with 69 women who had delivered in the past 12 months in hospitals in a rural County in Anhui Province. Data were transcribed, translated and analysed using the framework approach.

Results

Hospital delivery was preferred because it was considered safe. Home delivery was uncommon and unsupported by the health system. Expectations such as having skilled providers and privacy during childbirth were met. However, most women reported lack of cleanliness, companionship during labour, pain relief, and opportunity to participate in decision making as poor aspects of care. Absence of pain relief is one reason why women may opt for a caesarean section.

Conclusions

These findings illustrate that to improve quality of care it is crucial to build accountability and communication between providers, women and their families. Ensuring women’s participation in decision making needs to be addressed.
Appendix
Available only for authorised users
Literature
1.
2.
3.
van den Broek NR, Graham WJ. Quality of care for maternal and newborn health: the neglected agenda. BJOG. 2009;116(7):18–21.PubMedCrossRef
4.
Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, Heuton KR, et al. Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9947):980–1004.PubMedPubMedCentralCrossRef
5.
6.
Feng XL, Zhu J, Zhang L, Song L, Hipgrave D, Guo S, et al. Socio-economic disparities in maternal mortality in China between 1996 and 2006. BJOG. 2010;117(12):1527–36.PubMedCrossRef
7.
Yanqiu G, Ronsmans C, Lin A. Time trends and regional differences in maternal mortality in China from 2000 to 2005. Bull World Health Organ. 2009;87(12):913–20.PubMedPubMedCentralCrossRef
8.
Meng Q, Xu L, Zhang Y, Qian J, Cai M, Xin Y, et al. Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study. Lancet. 2012;379(9818):805–14.PubMedCrossRef
9.
Ministry of Health China, UNICEF, WHO, UNFPA. Joint review of maternal and child survival strategies in China. Beijing: Ministry of Health; 2006.
10.
Tao F, Huang K, Long X, Tolhurst R, Raven J. Low postnatal care rates in two rural counties in Anhui Province, China: perceptions of key stakeholders. Midwifery. 2011;27(5):707–15.PubMedCrossRef
11.
Raven J, Tolhurst R, Tang S, van den Broek N. What is quality in maternal and neonatal health care? Midwifery. 2011;28(5):e676–83.PubMedCrossRef
12.
Freedman LP. Using human rights in maternal mortality programs: from analysis to strategy. Int J Gynaecol Obstet. 2001;75(1):51–60.PubMedCrossRef
13.
Klemetti R, Che X, Gao Y, Raven J, Wu Z, Tang S, et al. Cesarean section delivery among primiparous women in rural China: an emerging epidemic. Am J Obstet Gynecol. 2010;202(1):65.e1-6.PubMedCrossRef
14.
Long Q, Zhang Y, Raven J, Wu Z, Bogg L, Tang S, et al. Giving birth at a health-care facility in rural China: is it affordable for the poor? Bull World Health Organ. 2011;89(2):144–52.PubMedCrossRef
15.
Harris A, Gao Y, Barclay L, Belton S, Yue ZW, Min H, et al. Consequences of birth policies and practices in post-reform China. Reprod Health Matters. 2007;15(30):114–24.PubMedCrossRef
16.
Harris A, Belton S, Barclay L, Fenwick J. Midwives in China: jie sheng po to zhu chan shi. Midwifery. 2009;25(2):203–12.PubMedCrossRef
17.
18.
Ritchie J, Spencer L, O'Connor W. Carrying out qualitative analysis. In: Ritchie J, Lewis J, editors. Qualitative research practice. London: Sage Publications; 2003. p. 219–62.
19.
MAXqda. MAXqda qualitative data analysis software. Marburg, Germany: Verbi Software; 2007.
20.
Karkee R, Lee AH, Binns CW. Bypassing birth centres for childbirth: an analysis of data from a community-based prospective cohort study in Nepal. Health Policy Plan. 2015;30(1):1–7.PubMedCrossRef
21.
Ith P, Dawson A, Homer CSE. Women’s perspective of maternity care in Cambodia. Women Birth. 2013;26:71–5.PubMedCrossRef
22.
Chaturvedi S, Randive B, Diwan V, De Costa A. Quality of obstetric referral services in India’s JSY cash transfer programme for institutional births: a study from Madhya Pradesh province. Plos One. 2014;9(5):e96773.PubMedPubMedCentralCrossRef
23.
Xu Q, Smith H, Zhou L, Liang J, Garner P. Evidence-based obstetrics in four hospitals in China: an observational study to explore clinical practice, women’s preferences and provider’s views. BMC Pregnancy Childbirth. 2001;1(1):1–7.CrossRef
24.
Baker A, Ferguson SA, Roach GD, Dawson D. Perceptions of labour pain by mothers and their attending midwives. J Adv Nurs. 2001;35(2):171–9.PubMedCrossRef
25.
Callister L. The pain of childbirth: perceptions of culturally diverse women. Pain Manag Nurs. 2003;4(4):145–54.PubMedCrossRef
26.
Cheung NF, Mander R, Wang X, Fu W, Zhou H, Zhang L. Views of Chinese women and health professionals about midwife-led care in China. Midwifery. 2011;27(6):842–7.PubMedCrossRef
27.
Gagnon AJ, Sandall J. Individual or group antenatal education for childbirth or parenthood, or both. Cochrane Database Syst Rev. 2007;3:CD002869.PubMed
28.
Stamler LL. The participants’ views of childbirth education: is there congruency with an enablement framework for patient education? J Adv Nurs. 1998;28(5):939.CrossRef
29.
30.
Lee LYK, Holroyd E. Evaluating the effect of childbirth education class: a mixed-method study. Int Nurs Rev. 2009;56(3):361–8.PubMedCrossRef
31.
Enkin M, Keirse M, Neilson J, Crowther C, Duley L, Hodnett ED, et al. Guide to effective care in pregnancy and childbirth. 3rd ed. Oxford: Oxford University Press; 2000.CrossRef
32.
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews. 2003;3:CD003766.PubMed
33.
Sercekus P, Okumus H. Fears associated with childbirth among nulliparous women in Turkey. Midwifery. 2009;25(2):155–62.PubMedCrossRef
34.
Fenwick J, Staff L, Gamble J, Creedy DK, Bayes S. Why do women request caesarean section in a normal, healthy first pregnancy? Midwifery. 2010;26(4):394–400.PubMedCrossRef
35.
Kasai KE, Nomura RMY, Benute GRG, de Lucia MCS, Zugaib M. Women’s opinions about mode of birth in Brazil: a qualitative study in a public teaching hospital. Midwifery. 2010;26(3):319–26.PubMedCrossRef
36.
Shahoei R, Riji HM, Saeedi ZA. Safe passage: pregnant Iranian Kurdish womens choice of childbirth method. J Adv Nurs. 2011;67(10):2130–8.PubMedCrossRef
37.
Tolhurst R, Huang K, Long Q, Zhang T, Xiao S, Tang X, et al. Utilisation, contents and costs of prenatal care under a rural health insurance (New Co-operative Medical System) in rural China: lessons from implementation. BMC Health Serv Res. 2010;10(1):1–11.CrossRef
38.
Gao Y, Barclay L. Availability and quality of emergency obstetric care in Shanxi Province, China. Int J Gynecol Obstet. 2010;110(2):181–5.CrossRef
39.
Hodnett ED. Pain and women’s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol. 2002;186(5):S160–72.PubMed
40.
Olsen DP, Honghong Wang DP, Pang S. Informed consent practices of Chinese nurse researchers. Nurs Ethics. 2010;17(2):179–87.PubMedCrossRef
41.
Cong Y. Doctor-family-patient relationship: the Chinese paradigm of informed consent. J Med Philos. 2004;29(2):149.PubMedCrossRef
Metadata
Title
The quality of childbirth care in China: women’s voices: a qualitative study
Authors
Joanna Raven
Nynke van den Broek
Fangbiao Tao
Huang Kun
Rachel Tolhurst
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2015
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0545-9

Other articles of this Issue 1/2015

BMC Pregnancy and Childbirth 1/2015 Go to the issue

Research article

Reasons for home delivery and use of traditional birth attendants in rural Zambia: a qualitative study

Research article

Fear of childbirth and elective caesarean section: a population-based study

Research article

A systematic review of randomised controlled trials on the effectiveness of exercise programs on Lumbo Pelvic Pain among postnatal women

Research article

Agreement between self-reported perinatal outcomes and administrative data in New South Wales, Australia

Research article

A cross-sectional analysis of perinatal depressive symptoms among Punjabi-speaking women: are they at risk?

Research article

The association between temporal changes in the use of obstetrical intervention and small- for-gestational age live births