Client-Related Factors Associated with a "Less than Good" Experience of Midwifery Care during Childbirth in the Netherlands

Carien I Baas, Therese A Wiegers, T Paul de Cock, Jan Jaap H M Erwich, Evelien R Spelten, Michiel R de Boer, Eileen K Hutton

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND: A "less than good" experience during childbirth can affect a mother's early interaction with her child and may significantly influence a woman's emotional well-being. In this study, we focus on clients who experienced midwifery care provided during childbirth as "less than good" care. The aim of this study was to understand the relationship between client-related factors and the experience of midwifery care during childbirth to improve this care.

METHODS: This study was part of the "DELIVER study" where mothers report on the care they received. We used generalized estimation equations to control for correlations within midwife practices. Forward multivariate logistic regression analyses were conducted to model the client-related factors associated with the experienced midwifery care during childbirth.

RESULTS: We included the responses of 2,377 women. In the multivariable logistic regression model, odds of reporting "less than good care" were significantly higher for women who experienced an unplanned cesarean birth (OR 2.21 [CI 1.19-4.09]), an instrumental birth (OR 1.55 [CI 1.08-2.23]), and less control during the dilation phase (OR 0.98 [CI 0.97-0.99]) and pushing phase (OR 0.98 [CI 0.97-0.99]).

DISCUSSION: Birth-related factors were more likely than maternal characteristics to be associated with the experience of midwifery care during childbirth. We conclude that there is room for midwives to improve their care for women during childbirth particularly in improving the patient centeredness of the care provider, using strategies to enhance sense of control, and focusing on the particular needs of those who experience instrumental vaginal or unplanned cesarean births.

Original languageEnglish
Pages (from-to)58-67
Number of pages10
JournalBirth : Issues in Perinatal Care
Volume44
Issue number1
DOIs
Publication statusPublished - Mar 2017

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Midwifery
Netherlands
Parturition
Logistic Models
Mothers
Dilatation
Patient Care
Regression Analysis

Keywords

  • Journal Article

Cite this

Baas, Carien I ; Wiegers, Therese A ; de Cock, T Paul ; Erwich, Jan Jaap H M ; Spelten, Evelien R ; de Boer, Michiel R ; Hutton, Eileen K. / Client-Related Factors Associated with a "Less than Good" Experience of Midwifery Care during Childbirth in the Netherlands. In: Birth : Issues in Perinatal Care. 2017 ; Vol. 44, No. 1. pp. 58-67.
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Client-Related Factors Associated with a "Less than Good" Experience of Midwifery Care during Childbirth in the Netherlands. / Baas, Carien I; Wiegers, Therese A; de Cock, T Paul; Erwich, Jan Jaap H M; Spelten, Evelien R; de Boer, Michiel R; Hutton, Eileen K.

In: Birth : Issues in Perinatal Care, Vol. 44, No. 1, 03.2017, p. 58-67.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Client-Related Factors Associated with a "Less than Good" Experience of Midwifery Care during Childbirth in the Netherlands

AU - Baas, Carien I

AU - Wiegers, Therese A

AU - de Cock, T Paul

AU - Erwich, Jan Jaap H M

AU - Spelten, Evelien R

AU - de Boer, Michiel R

AU - Hutton, Eileen K

N1 - © 2016 Wiley Periodicals, Inc.

PY - 2017/3

Y1 - 2017/3

N2 - BACKGROUND: A "less than good" experience during childbirth can affect a mother's early interaction with her child and may significantly influence a woman's emotional well-being. In this study, we focus on clients who experienced midwifery care provided during childbirth as "less than good" care. The aim of this study was to understand the relationship between client-related factors and the experience of midwifery care during childbirth to improve this care.METHODS: This study was part of the "DELIVER study" where mothers report on the care they received. We used generalized estimation equations to control for correlations within midwife practices. Forward multivariate logistic regression analyses were conducted to model the client-related factors associated with the experienced midwifery care during childbirth.RESULTS: We included the responses of 2,377 women. In the multivariable logistic regression model, odds of reporting "less than good care" were significantly higher for women who experienced an unplanned cesarean birth (OR 2.21 [CI 1.19-4.09]), an instrumental birth (OR 1.55 [CI 1.08-2.23]), and less control during the dilation phase (OR 0.98 [CI 0.97-0.99]) and pushing phase (OR 0.98 [CI 0.97-0.99]).DISCUSSION: Birth-related factors were more likely than maternal characteristics to be associated with the experience of midwifery care during childbirth. We conclude that there is room for midwives to improve their care for women during childbirth particularly in improving the patient centeredness of the care provider, using strategies to enhance sense of control, and focusing on the particular needs of those who experience instrumental vaginal or unplanned cesarean births.

AB - BACKGROUND: A "less than good" experience during childbirth can affect a mother's early interaction with her child and may significantly influence a woman's emotional well-being. In this study, we focus on clients who experienced midwifery care provided during childbirth as "less than good" care. The aim of this study was to understand the relationship between client-related factors and the experience of midwifery care during childbirth to improve this care.METHODS: This study was part of the "DELIVER study" where mothers report on the care they received. We used generalized estimation equations to control for correlations within midwife practices. Forward multivariate logistic regression analyses were conducted to model the client-related factors associated with the experienced midwifery care during childbirth.RESULTS: We included the responses of 2,377 women. In the multivariable logistic regression model, odds of reporting "less than good care" were significantly higher for women who experienced an unplanned cesarean birth (OR 2.21 [CI 1.19-4.09]), an instrumental birth (OR 1.55 [CI 1.08-2.23]), and less control during the dilation phase (OR 0.98 [CI 0.97-0.99]) and pushing phase (OR 0.98 [CI 0.97-0.99]).DISCUSSION: Birth-related factors were more likely than maternal characteristics to be associated with the experience of midwifery care during childbirth. We conclude that there is room for midwives to improve their care for women during childbirth particularly in improving the patient centeredness of the care provider, using strategies to enhance sense of control, and focusing on the particular needs of those who experience instrumental vaginal or unplanned cesarean births.

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DO - 10.1111/birt.12266

M3 - Article

VL - 44

SP - 58

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JO - Birth

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