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Continuity of carer and satisfaction
1Department of Nursing, Karolinska Institute, Stockholm, Sweden. U.Waldensrtom@mariadata.se
Objective:
To study the association between continuity of carer and satisfaction with antenatal, intrapartum and postpartum domiciliary care.
Design:
A descriptive study comparing satisfaction measures between women cared for by a known or unknown midwife. Data on satisfaction were extracted from the intervention group of a birth centre trial, and the names of the individual carers from two clinical databases kept at the birth centre.
Setting:
An in-hospital birth centre in Stockholm.
Subjects:
410 women who had been randomly allocated to birth centre care during pregnancy, and who had a normal vaginal delivery at the centre. Complete data, including the names of the caregivers and the women's satisfaction scores, were available in 175 cases (43%) during the antenatal episode, 404 cases (98%) during the intrapartum episode and in 254 cases (62%) during the episode of postpartum domiciliary care.
Main Outcome Measures:
Overall satisfaction with antenatal care, intrapartum care, labour and birth, and postpartum domiciliary care.
Findings:
No statistical differences were observed in satisfaction with antenatal care between women who had seen only one, two, or more than two midwives at their check-ups during pregnancy; in satisfaction with intrapartum care or the birth itself when comparing women who were delivered by a known or unknown midwife; or in satisfaction with domiciliary care when the midwife was known or unknown.
Conclusion:
The findings suggest that continuity of carer is less important in a birth centre. The high levels of satisfaction in women having birth centre care were probably more affected by the attitudes of the carers, the philosophy of care, and the nice and calm environment than by knowing the individual midwife well.