A comprehensive representation of the birth-experience: identification and prioritization of birth-specific domains based on a mixed-method design

BMC Pregnancy and Childbirth

M Elske van den Akker-van Marle¹  Anne M Stiggelbout¹  Kitty WM Bloemenkamp²  Johanna M Middeldorp²  Marlies E Rijnders³  Liv M Freeman²  Fania R Gärtner¹ 

[1] Department of Medical Decision Making, Leiden University Medical Centre, P.O.Box 9600, Leiden 2300RC, The Netherlands;Department of Obstetrics, Leiden University Medical Centre, P.O.Box 9600, Leiden 2300RC, The Netherlands;TNO Child Health, P.O.Box 2215, Leiden 2301 CE, The Netherlands

关键词: Cost-effectiveness;    Questionnaire;    Patient-reported outcomes;    Utility measure;    Labor and birth experience;   

Others  :  1127410
DOI  :  10.1186/1471-2393-14-147

 received in 2014-01-16, accepted in 2014-04-14,  发布年份 2014

【 摘 要 】

Background

In obstetrics, effectiveness and cost-effectiveness studies often present several specific outcomes with likely contradicting results and may not reflect what is important for women. A birth-specific outcome measure that combines the core domains into one utility score would solve this problem. The aim of this study was to investigate which domains are most relevant for women’s overall experience of labor and birth and should be included in such a measure.

Methods

A sequential mixed-method design with three steps was applied. First, the domains were identified by literature review and online focus groups consisting of pregnant women, women who recently gave birth, and their partners. Second, in a prioritizing task, women who recently gave birth and professionals (midwives, gynecologists, and researchers) selected and ranked their top seven domains. Third, the domains that were most frequently selected and had the highest ranking scores determined the basis for a consensus discussion with experts, whereby the definitive list of domains was formed.

Results

In the first step, 34 birth-specific domains were identified, which cover domains regarding the caregivers, intrapersonal aspects of the mother, partner support, and contextual and medical aspects of birth. Based on the prioritizing task results (step 2) of 96 women and 89 professionals, this list was reduced to 14 most relevant domains. In a consensus discussion, the final seven domains were selected by combining several of the 14 remaining domains and giving priority to the domains indicated to be relevant by mothers. The seven definite domains were: 1) availability of competent health professionals; 2) health professionals’ support; 3) provision of information; 4) health professionals’ response to needs and requests; 5) feelings of safety; 6) worries about the child’s health; and 7) experienced duration until the first contact with the child.

Conclusions

The experienced availability and quality of received care, concerns about safety and the baby’s health, and first contact with the baby are regarded as key aspects for a mother’s overall birth experience. Therefore, these domains are considered to be the most crucial for inclusion in a birth-specific outcome measure.

【 授权许可】

   
2014 Gärtner et al.; licensee BioMed Central Ltd.

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