Women's expectations of maternity services: A community-based survey.

Abstract

Background Examining women's preferences for maternity care is overdue. Understanding women's preferences and re-orienting services to meet their expectations is critical to improving health outcomes. Method A self-report survey of a convenience community sample of 63 women visiting a Maternity Coalition/Association for Improvements in Maternity Services stall at a Mother and Baby Expo in 2003. Results Over 95% of women ranked birth safety, bonding with the baby, feeling in control during birth, and postnatal care as "very important". Over 85% of women rated educational preparation for birth, the relationship with their caregiver, prenatal care, and breastfeeding successfully as "very important". Avoiding labour pain was considered less important by more women than any other item. Around half the respondents preferred their birth care to be from a chosen midwife with access to medical backup (57.9%, n = 37). Some women identified a lack of choice of care options with 45.9% (n = 17) reporting "little" or "no" choice in birth care for their previous birth. Poor quality care was also identified with 57.9% (n = 22) rating their postnatal care as "mediocre". Given assurance of equal safety and free care, 50% (n = 31) of participants would prefer to give birth at a birth centre and 24.2% (15 out of 63) would prefer a homebirth. Conclusion Factors associated with safety, control, continuity of care and successful mothering are perceived as important for many women. Some women perceived limited birth choices. More needs be done to align the provision of maternity services with women's preferred care options. Given the small self-select, non-representative sample, results should be interpreted with caution.