Creating an Optimality Index - Netherlands: a validation study.

Area of Science:

• Maternal and Child Health
• Healthcare Quality Improvement
• Midwifery Practice

Background:

• The Dutch maternity care system is transitioning to an integrated model.
• Midwives' roles are expanding to include more hospital births and medium-risk clients.
• A tool is needed for midwives to reflect on practices supporting physiological childbirth.

Purpose of the Study:

• To adapt the Optimality Index-US (OI-US) for the Dutch maternity care setting, creating the Optimality Index-NL (OI-NL).
• To validate the OI-NL as a tool for assessing optimal perinatal care processes and outcomes in the Netherlands.

Main Methods:

• The OI-US was translated and back-translated to develop the OI-NL.
• Maternity care experts (n=10) validated the OI-NL for face validity.
• Inter-rater reliability and discriminant validity were assessed using data from 266 women.

Main Results:

• The OI-NL demonstrated face validity based on expert input.
• Discriminant validity was confirmed through regression analyses for parity and care-setting (P<0.001).
• Inter-rater reliability was high at 98%, with minor sensitivity noted for the Apgar score item.

Conclusions:

• The OI-NL is a valid and reliable tool for the Dutch maternity care setting.
• It can be used for assessing evidence-based care, learning, and reflection.
• The OI-NL may help detect subtle increases in childbirth medicalization within the evolving Dutch system.