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Positive childbirth experiences in U.S. hospitals: a mixed methods analysis
Laura B Attanasio1, Marianne E McPherson, Katy B Kozhimannil
1Division of Health Policy and Management, University of Minnesota School of Public Health, 720 Delaware St. SE, MMC 729, Minneapolis, MN, 55455, USA, attan002@umn.edu.
Maternal and Child Health Journal
|September 28, 2013
Summary
Mothers’ confidence during childbirth is linked to their preparedness and support systems. Focusing on positive birth experiences can improve overall maternity care quality for mothers and infants.
Area of Science:
- Obstetrics and Gynecology
- Maternal Health
- Health Services Research
Background:
- Maternity care research in the US primarily focuses on preventing adverse events, neglecting positive birth experiences.
- Positive birth experiences are crucial for overall maternal well-being and can influence perceptions of care quality.
Purpose of the Study:
- To identify factors associated with maternal confidence and positive birth experiences in a national sample of US mothers.
- To explore the relationship between socio-demographic characteristics, clinical encounters, and health system factors with birth confidence.
Main Methods:
- A mixed-methods approach was used, combining quantitative analysis of a national survey (N=1,573) with qualitative analysis of open-ended responses.
- Quantitative analysis employed logistic regression to examine predictors of self-reported confidence during birth.
- Qualitative analysis explored themes related to positive birth experiences from mothers' narratives.
Main Results:
- Approximately 42% of mothers reported feeling confident during birth.
- Confidence entering labor was the strongest predictor of confidence during birth (AOR 12.88 nulliparous, 8.54 parous).
- For nulliparous women, Black and Hispanic race/ethnicity and partner support were positively associated with confidence; qualitative data highlighted communication and shared decision-making as key to positive experiences.
Conclusions:
- Confidence entering labor significantly predicts confidence during birth.
- Factors such as race/ethnicity, partner support, communication, and shared decision-making are vital for positive birth experiences.
- Prioritizing factors that promote positive birth experiences can enhance obstetric care quality and improve maternal and infant outcomes.
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