A recent study from QLD has surveyed 20,371 women who recently gave birth. Experiences of pregnancy, labour, birth and after birth care were assessed for the most recent birth, retrospectively four to five months after birth. The findings were very interesting! The only issues with the data and study is that mothers self-reported their answers and there was no verification of the information, or cross-checking with the midwives and obstetricians who provided the care. In other words, it was based on women’s subjective experiences rather than what might perhaps be factual or accurate. That being said, I wanted to draw a few points out of the study and elaborate more on them. The other aspect to raise is that I am making an inference when I write about this study: the study compared women who were cared for in public facilities (public hospital delivery suites and birth centres: women who for the most part would have had public care providers) with women who gave birth in private facilities. Those women would, for the most part, have booked with a private obstetrician and given birth under their care. So from this, I am inferring that public care = care from public hospital staff where the woman does not choose her care provider; and private facility care = private obstetric care. Being cared for well during pregnancy
The study found that women who birthed in private facilities were significantly more likely to say they were cared for very well during pregnancy than women who birthed in public facilities.
This is not surprising as women birthing in private facilities would be cared for in pregnancy by one obstetrician who was chosen by them.
Women who birthed in private facilities were also significantly more likely to report being treated with respect, treated with kindness and understanding, and treated as an individual by their pregnancy care providers.
This too is not surprising as their care provider was chosen by them.
Women who birthed in private facilities were also significantly more likely to say their pregnancy care providers were open and honest, respected their privacy, respected their decisions, and genuinely cared about their well-being.
This is all good news for continuity of carer models in pregnancy. Continuity of carer is very different to continuity of care. Continuity of care means continuous care from a small group of people – or even a large organisation – who shares a similar philosophy. It is interesting to see how far (and wide) this definition is stretched. Some would have us believe that we can give birth at the largest and busiest tertiary hospital as a public patient and receive continuity of care even though we had 30 care providers and never saw the same person twice. This definition – continuity of care – would still hold even in the above situation because all of the hospital staff would be working to the same philosophy and policies. Hence, continuity.
Continuity of carer, on the other hand, means that care is provided by one person for the most part. This is what we generally see with private obstetric care and private midwifery care.
Women who birthed in private facilities were more likely to say they were cared for very well in labour and birth than women who birthed in public facilities. However, the study found marked variations between public birth facilities with birth centres and midwifery-led units having the highest proportion of women saying they were cared for very well during their labour and birth.
This is good news for all those women who book with a private midwife or a public hospital-based caseload model.
Women who birthed in a private facility were generally more satisfied with the support they received after the birth, although only about 50% women were satisfied. The public hospital care rated even more poorly than that! This is evidence that the delivery of postnatal care needs to shift to meet the needs of women and babies.
Generally, women are discharged home early after the birth of their baby, with lengths of stay generally being around 24 – 48 hours in a public hospital. Women are then visited by a midwife once or twice following discharge; some hospitals provide more visits than this. Women who book with a private midwife generally enjoy more postnatal visits: 7 to 14 on average, with each visit lasting about an hour. A s well as this, women are generally prepared thoroughly in pregnancy for breastfeeding and baby care so that it is not so scary when the baby arrives.
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