Women's insights into choice, empowerment, and control in a subsequent pregnancy following a negative birth...

Lack of control and choice contributes to women experiencing birth as negative or distressing. Wanting a different experience in a subsequent pregnancy following a negative experience is invariably uppermost in women's minds. A woman-centred approach is associated with a more positive maternity care experience.

To establish women's agreement on elements of care that place them at the centre of their maternity care, following a negative birth experience and to identify enablers and constraints influencing perception of woman-centred care METHODS: This multimethod study combined quantitative and qualitative approaches to explore women's perspectives on aspects of woman-centred care. Fifty-seven multiparous pregnant women with a history of negative maternity experiences and/or fear of birth completed a survey assessing eleven co-designed elements of care identified in a modified Delphi study. Fourteen of these women participated in semi-structured interviews about their current maternity care. Quantitative data were analysed using descriptive statistics, and qualitative data using content and thematic analysis.

Women valued acknowledgment of previous experiences and comprehensive information supporting informed decision-making and control. Holistic care from known caregivers enhanced these outcomes, although some women felt centred in their care when supported by unknown clinicians who adopted woman-centred practices.

Meeting women's values, preferences, and informational needs promotes a sense of control and empowerment. Continuity of care enhances woman-centred approaches, though relational care can also be provided within fragmented systems. Continuity during pregnancy should be prioritised for women who have experienced a negative birth experience and have a current fear of birth.