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 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Evaluation of satisfaction with care in a midwifery unit and an obstetric unit: a randomized controlled trial of low-risk women

Authors: Stine Bernitz, Pål Øian, Leiv Sandvik, Ellen Blix

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

Login to get access

Abstract

Background

Satisfaction with birth care is part of quality assessment of care. The aim of this study was to investigate possible differences in satisfaction with intrapartum care among low-risk women, randomized to a midwifery unit or to an obstetric unit within the same hospital.

Methods

Randomized controlled trial conducted at the Department of Obstetrics and Gynecology, Østfold Hospital Trust, Norway. A total of 485 women with no expressed preference for level of birth care, assessed to be at low-risk at onset of spontaneous labor were included. To assess the overall satisfaction with intrapartum care, the Labour and Delivery Satisfaction Index (LADSI) questionnaire, was sent to the participants 6 months after birth. To assess women’s experience with intrapartum transfer, four additional items were added. In addition, we tested the effects of the following aspects on satisfaction; obstetrician involved, intrapartum transfer from the midwifery unit to the obstetric unit during labor, mode of delivery and epidural analgesia.

Results

Women randomized to the midwifery unit were significantly more satisfied with intrapartum care than those randomized to the obstetric unit (183 versus 176 of maximum 204 scoring points, mean difference 7.2, p = 0.002). No difference was found between the units for women who had an obstetrician involved during labor or delivery and who answered four additional questions on this aspect (mean item score 4.0 at the midwifery unit vs 4.3 at the obstetric unit, p = 0.3). Intrapartum transfer from the midwifery unit to an obstetric unit, operative delivery and epidurals influenced the level of overall satisfaction in a negative direction regardless of allocated unit (p < 0.001).

Conclusion

Low-risk women with no expressed preference for level of birth care were more satisfied if allocated to the midwifery unit compared to the obstetric unit.

Trial registration

The trial is registered at www.​clinicaltrials.​gov NCT00857129. Initially released 03/05/2009.
Literature
1.
Hodnett ED, Downe S, Walsh D. Alternative versus conventional institutional settings for birth. Cochrane Database Syst Rev. 2012;8:CD000012.
2.
Birthplace in England Collaborative G. Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ (Clinical research ed). 2011;343:d7400.CrossRef
3.
Gottvall K, Waldenstrom U, Tingstig C, Grunewald C. In-hospital birth center with the same medical guidelines as standard care: a comparative study of obstetric interventions and outcomes. Birth (Berkeley, Calif). 2011;38(2):120–8.CrossRef
4.
Homer CS, Friberg IK, Dias MA, ten Hoope-Bender P, Sandall J, Speciale AM, Bartlett LA. The projected effect of scaling up midwifery. Lancet. 2014;384(9948):1146–57.CrossRefPubMed
5.
Eide BI, Nilsen AB, Rasmussen S. Births in two different units in the same clinic-Aprospective study of healthy primiparous women. BMC Pregnancy Childbirth. 2009;9:25.CrossRefPubMedPubMedCentral
6.
Bernitz S, Aas E, Oian P. Economic evaluation of birth care in low-risk women. A comparison between a midwife-led birth unit and a standard obstetric unit within the same hospital in Norway. A randomised controlled trial. Midwifery. 2012;28(5):591–9.CrossRefPubMed
7.
Schroeder E, Petrou S, Patel N, Hollowell J, Puddicombe D, Redshaw M, Brocklehurst P, on behalf of the Birthplace in England Collaborative G. Cost effectiveness of alternative planned places of birth in woman at low risk of complications: evidence from the Birthplace in England national prospective cohort study. BMJ (Clinical research ed). 2012;344:e2292.
8.
National Institute of Health and Care Excellence. Intrapartum care. Care of healthy women and their babies during childbirth. Oxford: National Collaborating Centre for Women's and Children's Health; 2014.
9.
Byrne JP, Crowther CA, Moss JR. A randomised controlled trial comparing birthing centre care with delivery suite care in Adelaide, Australia. Aust N Z J Obstet Gynaecol. 2000;40(3):268–74.CrossRefPubMed
10.
Chapman MG, Jones M, Spring JE, De Swiet M, Chamberlain GV. The use of a birthroom: a randomized controlled trial comparing delivery with that in the labour ward. Br J Obstet Gynaecol. 1986;93(2):182–7.CrossRefPubMed
11.
Hundley VA, Cruickshank FM, Lang GD, Glazener CM, Milne JM, Turner M, Blyth D, Mollison J, Donaldson C. Midwife managed delivery unit: a randomised controlled comparison with consultant led care. BMJ (Clinical research ed). 1994;309(6966):1400–4.CrossRef
12.
MacVicar J, Dobbie G, Owen-Johnstone L, Jagger C, Hopkins M, Kennedy J. Simulated home delivery in hospital: a randomised controlled trial. Br J Obstet Gynaecol. 1993;100(4):316–23.CrossRefPubMed
13.
Waldenstrom U, Nilsson CA. Women’s satisfaction with birth center care: a randomized, controlled study. Birth (Berkeley, Calif). 1993;20(1):3–13.CrossRef
14.
Tingstig C, Gottvall K, Grunewald C, Waldenstrom U. Satisfaction with a modified form of in-hospital birth center care compared with standard maternity care. Birth (Berkeley, Calif). 2012;39(2):106–14.CrossRef
15.
Goberna-Tricas J, Banus-Gimenez MR, Palacio-Tauste A, Linares-Sancho S. Satisfaction with pregnancy and birth services: the quality of maternity care services as experienced by women. Midwifery. 2011;27(6):e231–7.CrossRefPubMed
16.
Melender HL. What constitutes a good childbirth? A qualitative study of pregnant Finnish women. J Midwifery Womens Health. 2006;51(5):331–9.CrossRefPubMed
17.
Britton JR. The assessment of satisfaction with care in the perinatal period. J Psychosom Obstet Gynaecol. 2012;33(2):37–44.CrossRefPubMed
18.
Brown S, Lumley J. Satisfaction with care in labor and birth: a survey of 790 Australian women. Birth (Berkeley, Calif). 1994;21(1):4–13.CrossRef
19.
Hodnett ED. Pain and women’s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol. 2002;186(5 Suppl Nature):S160–72.PubMed
20.
Waldenstrom U, Rudman A, Hildingsson I. Intrapartum and postpartum care in Sweden: women’s opinions and risk factors for not being satisfied. Acta Obstet Gynecol Scand. 2006;85(5):551–60.CrossRefPubMed
21.
22.
Biro MA, Waldenstrom U, Brown S, Pannifex JH. Satisfaction with team midwifery care for low- and high-risk women: a randomized controlled trial. Birth. 2003;30(1):1–10.CrossRefPubMed
23.
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev. 2013;8:CD004667.
24.
Waldenstrom U, Brown S, McLachlan H, Forster D, Brennecke S. Does team midwife care increase satisfaction with antenatal, intrapartum, and postpartum care? A randomized controlled trial. Birth. 2000;27(3):156–67.CrossRefPubMed
25.
Bernitz S, Rolland R, Blix E, Jacobsen M, Sjoborg K, Oian P. Is the operative delivery rate in low-risk women dependent on the level of birth care? A randomised controlled trial. BJOG. 2011;118(11):1357–64.CrossRefPubMedPubMedCentral
26.
Lomas J, Dore S, Enkin M, Mitchell A. The Labor and Delivery Satisfaction Index: the development and evaluation of a soft outcome measure. Birth (Berkeley, Calif). 1987;14(3):125–9.CrossRef
27.
Sawyer A, Ayers S, Abbott J, Gyte G, Rabe H, Duley L. Measures of satisfaction with care during labour and birth: a comparative review. BMC Pregnancy Childbirth. 2013;13:108.CrossRefPubMedPubMedCentral
28.
Harvey S, Rach D, Stainton MC, Jarrell J, Brant R. Evaluation of satisfaction with midwifery care. Midwifery. 2002;18(4):260–7.CrossRefPubMed
29.
30.
Waldenstrom U, Hildingsson I, Rubertsson C, Radestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004;31(1):17–27.CrossRefPubMed
31.
Spaich S, Welzel G, Berlit S, Temerinac D, Tuschy B, Sutterlin M, Kehl S. Mode of delivery and its influence on women’s satisfaction with childbirth. Eur J Obstet Gynecol Reprod Biol. 2013;170(2):401–6.CrossRefPubMed
32.
Anim-Somuah M, Smyth RM, Jones L. Epidural versus non-epidural or no analgesia in labour. Cochrane Database Syst Rev. 2011;12:CD000331.
Metadata
Title
Evaluation of satisfaction with care in a midwifery unit and an obstetric unit: a randomized controlled trial of low-risk women
Authors
Stine Bernitz
Pål Øian
Leiv Sandvik
Ellen Blix
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0932-x

Other articles of this Issue 1/2016

BMC Pregnancy and Childbirth 1/2016 Go to the issue

Research article

Are all immigrant mothers really at risk of low birth weight and perinatal mortality? The crucial role of socio-economic status

Erratum

Erratum to: Increasing prevalence and incidence of domestic violence during the pregnancy and one and a half year postpartum, as well as risk factors: −a longitudinal cohort study in Southern Sweden

Research article

A description of sleep behaviour in healthy late pregnancy, and the accuracy of self-reports

Study protocol

Institutionalizing postpartum intrauterine device (IUD) services in Sri Lanka, Tanzania, and Nepal: study protocol for a cluster-randomized stepped-wedge trial

Research article

Increased prevalence of some birth defects in Korea, 2009–2010

Study protocol

Study protocol of SWEPIS a Swedish multicentre register based randomised controlled trial to compare induction of labour at 41 completed gestational weeks versus expectant management and induction at 42 completed gestational weeks