1. Is maternity care in Scotland equitable? Results of a national maternity care survey
- Author
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Andrew Elders, Helen Cheyne, D. J. Hill, and Emma Milburn
- Subjects
Adult ,medicine.medical_specialty ,Activities of daily living ,media_common.quotation_subject ,Interpersonal communication ,Population health ,demographic characteristics ,Health Services Accessibility ,State Medicine ,care experience ,03 medical and health sciences ,Young Adult ,equity ,0302 clinical medicine ,Rurality ,Pregnancy ,quality of care ,Surveys and Questionnaires ,Obstetrics and Gynaecology ,Medicine ,Childbirth ,Humans ,maternity care ,Maternal Health Services ,030212 general & internal medicine ,Healthcare Disparities ,Socioeconomic status ,media_common ,030219 obstetrics & reproductive medicine ,business.industry ,Research ,questionnaire ,Multilevel model ,Age Factors ,General Medicine ,Parity ,Logistic Models ,Scotland ,Socioeconomic Factors ,Patient Satisfaction ,Family medicine ,Health Care Surveys ,Female ,business ,Welfare - Abstract
ObjectiveHigh-quality maternity care is key to long-term improvements in population health. However, even within developed welfare systems, some mothers and babies experience poorer care and outcomes. This study aimed to explore whether women’s experiences of maternity care in Scotland differs by their physical or sociodemographic characteristics.DesignSecondary analysis of the 2015 Scottish Maternity Care Experience Survey. The questionnaire was based on the Care Quality Commission English maternity survey.SettingNational Health Service maternity care in Scotland.ParticipantsThe survey was distributed to 5025 women who gave birth in Scotland during February and March 2015 with 2036 respondents (41%).Main outcome measuresThe questionnaire explored aspects of care processes and interpersonal care experienced from the first antenatal contact (booking) to 6 weeks following the birth. The analysis investigated whether experiences were related to age, parity, deprivation, rurality, self-reported general health or presence of a health condition that limited daily activities. Analysis used mixed effect multilevel models incorporating logistic regression.ResultsThere were associations between parity, age and deprivation with gestation at booking indicating that younger women, women from more deprived areas and multiparous women booked later. Women reporting generally poorer health were more likely to describe poorer care experiences in almost every domain including continuity, pain relief in labour, communication with staff, support and advice, involvement in decision making, confidence and trust and overall rating of care.ConclusionsWe found few differences in maternity care experience for women based on their physical or socioeconomic characteristics. Our findings indicate that maternity care in Scotland is generally equitable. However, the link between poorer general health after childbirth and poorer experience of maternity care is an important finding requiring further study.
- Published
- 2019