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Women's decision-making autonomy in Dutch maternity care
Maaike Vogels-Broeke1,2, Evelien Cellissen1, Darie Daemers1
1Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.
Birth (Berkeley, Calif.)
|August 17, 2022
Summary
Women generally feel autonomous in maternity care decisions, but autonomy decreases with obstetricians during late pregnancy and birth. Personal treatment and avoiding pressure enhance decision-making autonomy.
Area of Science:
- Maternal Health
- Obstetrics
- Patient Autonomy
Background:
- A positive childbirth experience is a key outcome in maternity care.
- Patient autonomy in decision-making is a significant component of positive birth experiences.
Purpose of the Study:
- To explore women's reported autonomy during care conversations with maternity practitioners.
- To investigate factors influencing autonomy during pregnancy and childbirth.
Main Methods:
- Cross-sectional survey of 3494 women in The Netherlands.
- Data collected on experiences during pregnancy and childbirth, focusing on decision-making conversations.
Main Results:
- Most women reported high autonomy, but it decreased with obstetricians compared to midwives in late pregnancy and childbirth.
- Personal treatment positively correlated with autonomy in conversations with both midwives and obstetricians.
- Nearly half of women experiencing interventions reported pressure to accept them.
Conclusions:
- While overall autonomy is high, improvements are needed, particularly in interactions with obstetricians.
- Enhancing autonomy involves personal treatment, shared decision-making, and avoiding pressure for interventions.
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