Women’s dissatisfaction with inappropriate behavior by health care workers during childbirth care in France: A survey study
Background Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and behavior. Few studies have examined the proportion of women in Western countries expressing dissatisfaction with such inappropriate or incon...
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| Published in: | Birth (Berkeley, Calif.) Vol. 48; no. 3; pp. 328 - 337 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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United States
Wiley Subscription Services, Inc
01-09-2021
Wiley |
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| Abstract | Background
Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and behavior. Few studies have examined the proportion of women in Western countries expressing dissatisfaction with such inappropriate or inconsiderate behavior. This study evaluated this proportion in a sample presumably representative of French maternity units.
Methods
This prospective multicenter study, using data from a selfadministered questionnaire, took place in 25 French maternity units during one week in September 2018. The primary outcome measure was mothers' self‐reported dissatisfaction with blatantly inappropriate behavior (ie, inappropriate attitude, inadequate respect for privacy, insufficient gentleness of care, and/or inappropriate language) by health care workers in the delivery room. The secondary outcome was their self‐reported dissatisfaction with these workers' inconsiderate behavior (ie, unclear and inappropriate information, insufficient participation in decision‐making, or deficient consideration of pain).
Results
Of 803 potentially eligible women, 627 completed the questionnaire after childbirth; 5.62% (35/623, 95% CI: 3.94‐7.73) reported dissatisfaction with blatantly inappropriate behaviors and 9.79% (61/623, 95% CI: 7.57‐12.40) with inconsiderate behaviors. The main causes of dissatisfaction reported by women in this survey were the inadequate consideration of their pain and the failure to share decision‐making.
Conclusions
Most of the women were satisfied with how health care workers behaved towards them in the delivery room. Nonetheless, health care staff must be aware of women's demands for greater consideration of their expressions of pain and of their voice in decisions. |
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| AbstractList | Background
Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and behavior. Few studies have examined the proportion of women in Western countries expressing dissatisfaction with such inappropriate or inconsiderate behavior. This study evaluated this proportion in a sample presumably representative of French maternity units.
Methods
This prospective multicenter study, using data from a selfadministered questionnaire, took place in 25 French maternity units during one week in September 2018. The primary outcome measure was mothers' self‐reported dissatisfaction with blatantly inappropriate behavior (ie, inappropriate attitude, inadequate respect for privacy, insufficient gentleness of care, and/or inappropriate language) by health care workers in the delivery room. The secondary outcome was their self‐reported dissatisfaction with these workers' inconsiderate behavior (ie, unclear and inappropriate information, insufficient participation in decision‐making, or deficient consideration of pain).
Results
Of 803 potentially eligible women, 627 completed the questionnaire after childbirth; 5.62% (35/623, 95% CI: 3.94‐7.73) reported dissatisfaction with blatantly inappropriate behaviors and 9.79% (61/623, 95% CI: 7.57‐12.40) with inconsiderate behaviors. The main causes of dissatisfaction reported by women in this survey were the inadequate consideration of their pain and the failure to share decision‐making.
Conclusions
Most of the women were satisfied with how health care workers behaved towards them in the delivery room. Nonetheless, health care staff must be aware of women's demands for greater consideration of their expressions of pain and of their voice in decisions. BackgroundQuality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and behavior. Few studies have examined the proportion of women in Western countries expressing dissatisfaction with such inappropriate or inconsiderate behavior. This study evaluated this proportion in a sample presumably representative of French maternity units.MethodsThis prospective multicenter study, using data from a selfadministered questionnaire, took place in 25 French maternity units during one week in September 2018. The primary outcome measure was mothers' self‐reported dissatisfaction with blatantly inappropriate behavior (ie, inappropriate attitude, inadequate respect for privacy, insufficient gentleness of care, and/or inappropriate language) by health care workers in the delivery room. The secondary outcome was their self‐reported dissatisfaction with these workers' inconsiderate behavior (ie, unclear and inappropriate information, insufficient participation in decision‐making, or deficient consideration of pain).ResultsOf 803 potentially eligible women, 627 completed the questionnaire after childbirth; 5.62% (35/623, 95% CI: 3.94‐7.73) reported dissatisfaction with blatantly inappropriate behaviors and 9.79% (61/623, 95% CI: 7.57‐12.40) with inconsiderate behaviors. The main causes of dissatisfaction reported by women in this survey were the inadequate consideration of their pain and the failure to share decision‐making.ConclusionsMost of the women were satisfied with how health care workers behaved towards them in the delivery room. Nonetheless, health care staff must be aware of women's demands for greater consideration of their expressions of pain and of their voice in decisions. Abstract Background Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and behavior. Few studies have examined the proportion of women in Western countries expressing dissatisfaction with such inappropriate or inconsiderate behavior. This study evaluated this proportion in a sample presumably representative of French maternity units. Methods This prospective multicenter study, using data from a selfadministered questionnaire, took place in 25 French maternity units during one week in September 2018. The primary outcome measure was mothers' self‐reported dissatisfaction with blatantly inappropriate behavior (ie, inappropriate attitude, inadequate respect for privacy, insufficient gentleness of care, and/or inappropriate language) by health care workers in the delivery room. The secondary outcome was their self‐reported dissatisfaction with these workers' inconsiderate behavior (ie, unclear and inappropriate information, insufficient participation in decision‐making, or deficient consideration of pain). Results Of 803 potentially eligible women, 627 completed the questionnaire after childbirth; 5.62% (35/623, 95% CI: 3.94‐7.73) reported dissatisfaction with blatantly inappropriate behaviors and 9.79% (61/623, 95% CI: 7.57‐12.40) with inconsiderate behaviors. The main causes of dissatisfaction reported by women in this survey were the inadequate consideration of their pain and the failure to share decision‐making. Conclusions Most of the women were satisfied with how health care workers behaved towards them in the delivery room. Nonetheless, health care staff must be aware of women's demands for greater consideration of their expressions of pain and of their voice in decisions. Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and behavior. Few studies have examined the proportion of women in Western countries expressing dissatisfaction with such inappropriate or inconsiderate behavior. This study evaluated this proportion in a sample presumably representative of French maternity units. This prospective multicenter study, using data from a selfadministered questionnaire, took place in 25 French maternity units during one week in September 2018. The primary outcome measure was mothers' self-reported dissatisfaction with blatantly inappropriate behavior (ie, inappropriate attitude, inadequate respect for privacy, insufficient gentleness of care, and/or inappropriate language) by health care workers in the delivery room. The secondary outcome was their self-reported dissatisfaction with these workers' inconsiderate behavior (ie, unclear and inappropriate information, insufficient participation in decision-making, or deficient consideration of pain). Of 803 potentially eligible women, 627 completed the questionnaire after childbirth; 5.62% (35/623, 95% CI: 3.94-7.73) reported dissatisfaction with blatantly inappropriate behaviors and 9.79% (61/623, 95% CI: 7.57-12.40) with inconsiderate behaviors. The main causes of dissatisfaction reported by women in this survey were the inadequate consideration of their pain and the failure to share decision-making. Most of the women were satisfied with how health care workers behaved towards them in the delivery room. Nonetheless, health care staff must be aware of women's demands for greater consideration of their expressions of pain and of their voice in decisions. Background As part of a decades-long process of restructuring primary care, independent (also known as community) healthcare workers are being encouraged to work in groups to facilitate their coordination and continuity of care in France. French independent midwives perform about half of the early prenatal interviews that identify mothers' needs during pregnancy and then refer them to the appropriate resources. The French government, however, structured the COVID-19 pandemic response around public health institutions and did not directly mobilise these community healthcare workers during the lockdown phase. These responses have raised questions about their role within the healthcare system in crises. This survey’s main objectives were to estimate the proportion of independent midwives who experienced new difficulties in referring women to healthcare facilities or other caregivers and in collaborating with hospitals during the first stage of this pandemic. The secondary objective was to estimate the proportion, according to their mode of practice, of independent midwives who considered that all the women under their care had risked harm due to failed or delayed referral to care. Methods We conducted an online national survey addressed to independent midwives in France from 29 April to 15 May 2020, around the end of the first lockdown (17 March–11 May, 2020). Results Of the 5264 registered independent midwives in France, 1491 (28.3%) responded; 64.7% reported new or greater problems during the pandemic in referring women to health facilities or care-providers, social workers in particular, and 71.0% reported new difficulties collaborating with hospitals. Nearly half (46.2%) the respondents considered that all the women in their care had experienced, to varying degrees, a lack of or delay in care that could have affected their health. This proportion did not differ according to the midwives’ form of practice: solo practice, group practice with other midwives only, or group practice with at least two types of healthcare professionals. Conclusions The pandemic has degraded the quality of pregnant women’s care in France and challenged the French model of care, which is highly compartmentalised between an almost exclusively independent primary care (community) sector and a predominantly salaried secondary care (hospital) sector. |
| Author | Haegenaer, Christelle Gonnaud, Françoise Sanlaville, Aude Derrier Huissoud, Cyril Dupont, Corinne Romegoux, Pauline Bouty, Floriane Morgan, Cécile Gaucherand, Pascal Andre, Claire Douet, Agathe Lopez, Aurélie Ecochard, Rene Guerin, Myriam Large, Delphine Payan, Florence Silvestre, Marie Amélie Coche, Sylvie Lasfer, Nanoucha Levrat, Catherine Cosset, Mélanie Schwich, Diane Burnier, Charlène Riffard, Angélique Escolano, Clarisse Irabide Dolezon, Danielle Corgnet, Nathalie Bouveret, Laetitia Maiga, Gaelle Pollet, Eugénie Rome‐Esteoule, Isabelle Costa, Marion Battut, Audery Cloudstone, Anne Ruat, Nadine Bonnefond, Annie Martinez, Nausicaa Gindre, Marianne Facchin, Florence Blanc, Emmanuelle Gomart, Charlotte Roch, Nathalie Benoit, Laura Mely, Françoise Gherici, Naima Fabre, Stéphanie Colin, Cyrille Bonjean, Simone‐Laure Pinget, Caroline Favre, Sandra Tonda, Joelle Desparain, Béatrice Boudet, Chantal Lafuente, Marie Blanc, Juliette Taillieu, Louise Touzet, Sandrine Perrin, Sidonie Gerentes, Cyrielle Rudigoz, René‐Charles Bouvet, Lionel Gaucher, Laure |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33686732$$D View this record in MEDLINE/PubMed https://hal.science/hal-04177976$$DView record in HAL |
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| ContentType | Journal Article |
| Contributor | Haegenaer, Christelle Sanlaville, Aude Derrier Romegoux, Pauline Bouty, Floriane Morgan, Cécile Andre, Claire Douet, Agathe Lopez, Aurélie Guerin, Myriam Large, Delphine Payan, Florence Silvestre, Marie Amélie Coche, Sylvie Lasfer, Nanoucha Levrat, Catherine Cosset, Mélanie Schwich, Diane Burnier, Charlène Riffard, Angélique Escolano, Clarisse Irabide Dolezon, Danielle Corgnet, Nathalie Maiga, Gaelle Pollet, Eugénie Costa, Marion Battut, Audery Cloudstone, Anne Ruat, Nadine Bonnefond, Annie Martinez, Nausicaa Gindre, Marianne Facchin, Florence Blanc, Emmanuelle Rome-Esteoule, Isabelle Gomart, Charlotte Roch, Nathalie Benoit, Laura Mely, Françoise Gherici, Naima Fabre, Stéphanie Pinget, Caroline Favre, Sandra Tonda, Joelle Desparain, Béatrice Boudet, Chantal Lafuente, Marie Blanc, Juliette Taillieu, Louise Perrin, Sidonie Bonjean, Simone-Laure Gerentes, Cyrielle Almodovar, Alain Digarcher, Maud Poulet, Elisabeth Delon, Pauline Louet, Claudie Gonnon, Alice Aboubi, Charifa Goubault, Jessica Rolin, Christèle Senghor, Mathilde Pinceloup, Claire Caudev |
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| Keywords | patient satisfaction questionnaires surveys health personnel Midwifery Obstetric violence Violences obstétricales Sage-femme Maïeutique |
| Language | English |
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| References_xml | – volume: 4 year: 2016 article-title: Midwife‐led continuity models versus other models of care for childbearing women publication-title: Cochrane Database Syst Rev – volume: 120 start-page: 257 issue: 3 year: 2013 end-page: 266 article-title: Decision aids to improve informed decision‐making in pregnancy care: A systematic review publication-title: BJOG Int J Obstet Gynaecol – start-page: 164 year: 2018 – volume: 5 year: 2018 article-title: Epidural versus non‐epidural or no analgesia for pain management in labour publication-title: Cochrane Database of Syst Rev – volume: 202 start-page: 1323 issue: 7 year: 2018 end-page: 1340 article-title: De la bientraitance en obstétrique publication-title: Bulletin de l'Académie Nationale de Médecine – volume: 59 start-page: 4 year: 2018 end-page: 16 article-title: Interventions to support effective communication between maternity care staff and women in labour: A mixed‐methods systematic review publication-title: Midwifery – volume: 359 start-page: 1681 issue: 9318 year: 2002 end-page: 1685 article-title: Violence against women in health‐care institutions: an emerging problem publication-title: Lancet Lond Engl – volume: 67 start-page: 1 issue: 1 year: 2015 end-page: 48 article-title: Fitting linear mixed‐effects models using ime4 publication-title: J Stat Softw – volume: 16 issue: 1 year: 2016 article-title: Evaluation of satisfaction with care in a midwifery unit and an obstetric unit: a randomized controlled trial of low‐risk women publication-title: BMC Pregnancy Childbirth – volume: 94 start-page: 508 issue: 5 year: 2015 end-page: 517 article-title: Prevalence of experienced abuse in healthcare and associated obstetric characteristics in six European countries publication-title: Acta Obstet Gynecol Scand – volume: 12 issue: 6 year: 2015 article-title: The mistreatment of women during childbirth in health facilities globally: a mixed‐methods systematic review publication-title: PLoS Med – year: 2018 – volume: 394 start-page: 1750 issue: 10210 year: 2019 end-page: 1763 article-title: How women are treated during facility‐based childbirth in four countries: A cross‐sectional study with labour observations and community‐based surveys publication-title: The Lancet – year: 2014 – volume: 31 start-page: 423 issue: 2 year: 1975 end-page: 447 article-title: Best linear unbiased estimation and prediction under a selection model publication-title: Biometrics – volume: 102 start-page: F364 issue: 4 year: 2017 end-page: F368 article-title: Eight principles for patient‐centred and family‐centred care for newborns in the neonatal intensive care unit publication-title: Arch Dis Child Fetal Neonatal Ed – year: 2012 – volume: 29 start-page: 450 issue: 5 year: 2016 end-page: 454 article-title: Women’s experience of childbirth – A five year follow‐up of the randomised controlled trial “Ready for Child Trial” publication-title: Women and Birth – volume: 122 start-page: 1045 issue: 8 year: 2015 end-page: 1049 article-title: Quality of care for pregnant women and newborns‐the WHO vision publication-title: BJOG Int J Obstet Gynaecol – volume: 31 start-page: 102 issue: 2 year: 2004 end-page: 107 article-title: Why do some women change their opinion about childbirth over time? publication-title: Birth Berkeley Calif – volume: 21 start-page: 4 issue: 1 year: 1994 end-page: 13 article-title: Satisfaction with care in labor and birth: a survey of 790 Australian women publication-title: Birth Berkeley Calif – volume: 295 start-page: 1127 issue: 5 year: 2017 end-page: 1133 article-title: The influence of the systematic birth preparation program on childbirth satisfaction publication-title: Arch Gynecol Obstet – volume: 36 start-page: 92 issue: 1 year: 2008 end-page: 98 article-title: When the helper humiliates the patient: a qualitative study about unintended intimidations publication-title: Scand J Public Health – year: 2020 – volume: 224 start-page: 208 year: 2018 end-page: 209 article-title: Abuse and disrespect in childbirth assistance in Italy: a community‐based survey publication-title: Eur J Obstet Gynecol Reprod Biol – volume: 97 start-page: 563 issue: 8 year: 2019 end-page: 569 article-title: When the patient is the expert: measuring patient experience and satisfaction with care publication-title: Bull World Health Organ – volume: 45 start-page: 245 issue: 3 year: 2018 end-page: 254 article-title: Needs of parents and professionals to improve shared decision‐making in interprofessional maternity care practice: a qualitative study publication-title: Birth – year: 2017 – year: 2019 – volume: 74 start-page: 1112 issue: 9 year: 2019 end-page: 1120 article-title: Determinants of women’s dissatisfaction with anaesthesia care in labour and delivery publication-title: Anaesthesia – ident: e_1_2_11_2_1 doi: 10.1111/1471-0528.13451 – ident: e_1_2_11_19_1 – ident: e_1_2_11_29_1 doi: 10.1136/archdischild-2016-312180 – ident: e_1_2_11_18_1 doi: 10.1371/journal.pmed.1001847 – ident: e_1_2_11_10_1 – ident: e_1_2_11_14_1 doi: 10.1111/aogs.12593 – ident: e_1_2_11_4_1 doi: 10.1016/S0140-6736(02)08592-6 – volume-title: Bilan Démographique 2018 year: 2019 ident: e_1_2_11_20_1 contributor: fullname: Champion J‐B – ident: e_1_2_11_25_1 doi: 10.1111/j.1523-536X.1994.tb00909.x – ident: e_1_2_11_6_1 doi: 10.1016/j.ejogrb.2018.03.055 – ident: e_1_2_11_13_1 doi: 10.2307/2529430 – ident: e_1_2_11_12_1 doi: 10.18637/jss.v067.i01 – ident: e_1_2_11_22_1 doi: 10.1111/anae.14756 – volume-title: Éléments Pour Élaborer Une Aide à La Prise de Décision Partagée Entre Patient et Professionnel de Santé ‐ Recommandation de Bonne Pratique year: 2018 ident: e_1_2_11_28_1 – ident: e_1_2_11_5_1 doi: 10.1177/1403494807085358 – ident: e_1_2_11_9_1 – volume-title: Respectful maternity care: Country experiences year: 2012 ident: e_1_2_11_3_1 contributor: fullname: Reis V – ident: e_1_2_11_26_1 doi: 10.1111/birt.12379 – ident: e_1_2_11_8_1 doi: 10.1016/S0001-4079(19)30199-2 – ident: e_1_2_11_16_1 doi: 10.1111/j.0730-7659.2004.00287.x – ident: e_1_2_11_11_1 – volume: 4 start-page: CD004667 year: 2016 ident: e_1_2_11_24_1 article-title: Midwife‐led continuity models versus other models of care for childbearing women publication-title: Cochrane Database Syst Rev contributor: fullname: Sandall J – ident: e_1_2_11_27_1 doi: 10.1111/1471-0528.12060 – volume: 5 start-page: CD000331 year: 2018 ident: e_1_2_11_21_1 article-title: Epidural versus non‐epidural or no analgesia for pain management in labour publication-title: Cochrane Database of Syst Rev contributor: fullname: Anim‐Somuah M – ident: e_1_2_11_15_1 doi: 10.1016/j.wombi.2016.02.003 – ident: e_1_2_11_7_1 doi: 10.2471/BLT.18.225201 – ident: e_1_2_11_31_1 doi: 10.1016/j.midw.2017.12.014 – ident: e_1_2_11_17_1 doi: 10.1016/S0140-6736(19)31992-0 – ident: e_1_2_11_30_1 doi: 10.1007/s00404-017-4345-5 – ident: e_1_2_11_23_1 doi: 10.1186/s12884-016-0932-x |
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Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and... Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and behavior.... Abstract Background Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate... BackgroundQuality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and... BACKGROUNDQuality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and... Background As part of a decades-long process of restructuring primary care, independent (also known as community) healthcare workers are being encouraged to... |
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| SubjectTerms | Attitudes Behavior Childbirth & labor Clinical decision making Discontent Gynecology and obstetrics Health behavior Health care health personnel Human health and pathology Inappropriateness Life Sciences Maternity units Medical personnel Mothers Multicenter studies Pain Patient satisfaction Polls & surveys Privacy Quality of care Questionnaires surveys Women Womens health Workers |
| Title | Women’s dissatisfaction with inappropriate behavior by health care workers during childbirth care in France: A survey study |
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