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User experiences of pregnancy, birth and postnatal care. National results


Key message

The results from the survey show that many women and partners have positive experiences with pregnancy, birth and postnatal care, but also that several areas would benefit from improvement. The poorest experiences are during postnatal stay, and it is here that the experiences vary the most.Pregnancy control by midwife got the best scores, while information about the woman's health at the public health centre got the lowest. Considering the four phases, the experiences during birth received the most positive descriptions and the stay in the postnatal unit has received the poorest. The indexes describing the postnatal stay has the largest dispersion in the women's responses, overall. 

Summary

Background

This national survey was commissioned in the White Paper “A happy event. A coherent pregnancy, birth and postnatal care”.

The objective was to collect user experiences with pregnancy, birth and maternity care in Norway from women who have given birth and their partners. We carried out a development project in advance to ensure that the survey was well adapted to the services in Norway.

This report shows the results on a national level. We have produced separate reports for each institution as well as a separate method description report.

Method

We conducted the survey as a postal survey. The Medical Birth Registry (MBR) established the sample among women over 16 years who had given birth in the last quarter of 2011 at one of the country's maternity units. We excluded births where the mother or child died in connection with the birth or during the collection period. Partners were included via the women in the sample.

From institutions with more than 400 births in the period, 400 women were randomly selected, and from institutions with fewer than 400 births in the inclusion period all the women were included consecutively. We contacted the included women by letter about 17 weeks after birth and asked them to participate via the internet or to fill out a paper form. Two reminders were sent to women who did not respond. After the mailing to the women was completed, we sent a letter to the partners via the women. Partners that did not respond received a reminder once.

The questionnaires were both in English and Norwegian.

We made the women's questionnaire for the internet and for paper. It had five parts:

  1. Pregnancy care, 43 questions
  2. Birth, 27 questions
  3. The stay in the maternity ward, 30 questions
  4. Contact with the public health centre after birth, 32 questions
  5. Background information, nine questions

In the printed questionnaire, we left the last page blank so that respondents could elaborate on their experiences or comment on the survey in free text. Women who responded via internet did not have that option.

The partners received an online questionnaire only, which consisted of five parts:

  1. Pregnancy care, 14 questions
  2. Birth, eight questions
  3. The stay in the maternity ward, nine questions
  4. Contact with the public health centre after birth, seven questions
  5. Background information, ten questions

We entered the responses from the survey in a data set without uniquely personal characteristics. In January 2013 we added medical information from MFR by means of a unique case number. Statistics Norway added information about the country of birth to the case numbers, making it possible to process the data in terms of differences between women with different national backgrounds.

In order to present condensed and robust results, 16 indexes was constructed based on single questions from the women's questionnaire and six indexes based on single questions from the partner's questionnaire.To enhance representativeness we weighted the material.

Results

The number of eligible women was 8670, and 4904 (56.6%) responded. The number of partners who responded was 1764, and this represents 21.3% of the sample at the time of mailing. We received 636 free text comments.

Table 1 shows the indexes together, and in a course perspective. It should be read with caution, partly because the contents of the indexes with the same title vary somewhat, and because the number of answers that the average is calculated from vary. All scores are well within the positive half of the scale. Pregnancy control by midwife got the best scores, while information about the woman's health at the public health centre got the lowest. Considering the four phases, the experiences during birth received the most positive descriptions and the stay in the postnatal unit has received the poorest. The indexes describing the postnatal stay has the largest dispersion in the women's responses, overall.

The table in PDF-format.

We compared the experiences of women born in different groups of countries, 4028 women from Norway, 450 from EU / EEA countries except Norway, USA, Canada, Australia and New Zealand and 426 women from Asia, Africa, Latin America, Oceania except Australia and New Zealand, and Europe outside the EEA. There were no consistent differences in index scores between these groups, and which group had described better or poorer experiences varies from index to index. The index about information given during antenatal care had the strongest influence on how satisfied the women were with this care. The index resources and organization was the one with most impact on overall satisfaction with the three later phases of the care course. Most of the free text answers contained comments to the topics in the questionnaire.

Conclusion

The results from the survey show that many women and partners have positive experiences with pregnancy, birth and postnatal care, but also that several areas would benefit from improvement. The poorest experiences are during postnatal stay, and it is here that the experiences vary the most.

Authors

About this publication

  • Year: 2013
  • ISSN (digital): 1890-1565
  • ISBN (digital): 978-82-8121-843-7