Purpose: Pregnancy and childbirth are among the most common reasons for women to access health services, which makes assessing and enhancing the quality of obstetric care an integral part of efforts to improve health and healthcare delivery. Though patient satisfaction is an important and relevant quality indicator, no adequate measure of satisfaction with labor and delivery experience currently exists, and there has been surprisingly little systematic evaluation of how women feel about their experience. As part of our work in developing a more nuanced measure of satisfaction in this context, we sought to explore the underlying factors associated with satisfaction with labor and delivery experience.
Method: After performing a detailed literature review, we conducted 6 focus groups with 41 women who had given birth within the past 6 months. We created a pool of 24 items adapted from pre-existing instruments and derived from the focus group analysis. This item pool was administered to 115 recently postpartum women. We used exploratory factor analysis to assess the underlying dimensions of satisfaction with labor and delivery experience.
Result: In addition to a general global satisfaction assessment, four dimensions of satisfaction with labor and delivery emerged: quality of communication with labor and delivery providers (average loading 74), control and self efficacy (average loading 58), participation in decision making (average loading 60), and time spent with the baby immediately following delivery (average loading 75). This structure fit the satisfaction data well (Comparitive Fit Index = 0.97).
Conclusion: Aspects of communication with care providers, participation in decision making, control over the delivery experience, and time spent with the baby immediately following delivery are important to women’s satisfaction with labor and delivery experience. This assessment can help to delineate factors that could be changed in order to improve the patient experience of care. Future efforts will focus on further refining and validating these measures in other samples of recently post partum women.
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