Prevalence and risk factors of maternal dissatisfaction after vaginal delivery: A multicenter prospective study

To evaluate the prevalence and risk factors of maternal dissatisfaction 2 days after a singleton vaginal delivery at or near term.

We conducted a planned ancillary cohort study of the TRanexamic Acid for Preventing Postpartum Hemorrhage After Vaginal Delivery (TRAAP) randomized controlled trial. Maternal dissatisfaction, related to the birth and to the subsequent hospital stay, was assessed 2 days postpartum by two self-administered questions: "Are you satisfied with the care you received during your child's birth?" and "Are you satisfied with the care you have received during your hospital stay?". Satisfaction was defined by answers of "extremely satisfied" or "very satisfied," and dissatisfaction by the responses "moderately satisfied," "not very satisfied," or "not at all satisfied". Their association with maternal dissatisfaction was analyzed by random-effects logistic regression.

The prevalence of maternal dissatisfaction with the birth was 2.9%, and with the hospital stay 9.5%. Characteristics associated with a higher risk of maternal dissatisfaction with the birth were labor exceeding 6 h, bad memories of the birth and, only for women without complicated deliveries, manual examination of the uterine cavity. The only characteristic associated with a higher risk of dissatisfaction with the hospital stay was non-French nationality. None of the postpartum hemorrhage, third- or fourth-degree perineal lacerations, operative vaginal delivery, episiotomy and uterine massage were associated with a higher risk of maternal dissatisfaction.

Maternal dissatisfaction was low after singleton vaginal deliveries at or near term. Strategies aiming to avoid labor longer than 6 h and manual examination of the uterine cavity may decrease maternal dissatisfaction after delivery.