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Assessing Women's Preferences for Intrapartum Care

Authors

  • Vanora Hundley BN, RGN, RM, MSc, PhD,

    1. Vanora Hundley is Lecturer at the Centre for Advanced Studies in Nursing; Mandy Ryan is MRC Senior Fellow and Reader at the Health Economics Research Unit; and Wendy Graham is Director of the Dugald Baird Centre for Research in Women's Health, University of Aberdeen, Aberdeen, Scotland.
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  • Mandy Ryan BA (Econ), MSc, PhD,

    1. Vanora Hundley is Lecturer at the Centre for Advanced Studies in Nursing; Mandy Ryan is MRC Senior Fellow and Reader at the Health Economics Research Unit; and Wendy Graham is Director of the Dugald Baird Centre for Research in Women's Health, University of Aberdeen, Aberdeen, Scotland.
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  • Wendy Graham DPhil (Oxon)

    1. Vanora Hundley is Lecturer at the Centre for Advanced Studies in Nursing; Mandy Ryan is MRC Senior Fellow and Reader at the Health Economics Research Unit; and Wendy Graham is Director of the Dugald Baird Centre for Research in Women's Health, University of Aberdeen, Aberdeen, Scotland.
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Address correspondence to Vanora Hundley, Centre for Advanced Studies in Nursing, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen, AB25 2AY, Scotland.

Abstract

Background:Recent government reports have recommended involving consumers in the planning of health services. Although satisfaction surveys have traditionally been used, they have several limitations. This paper describes a relatively new method of eliciting consumer preferences that allows respondents (women) to indicate the importance that they attribute to specific aspects of a service. The aim was to explore the feasibility of using a discrete choice experiment to assess the importance to women of different aspects of intrapartum care.Methods:In this pilot study of 301 women at low obstetric risk, data were collected using an anonymous self-complete questionnaire given to each participant by the midwife at the booking visit.Results:The results of the regression model suggest that respondents prefer maternity units that offer greater continuity of caregiver, more methods of pain relief, continuous fetal heart rate monitoring, a homely appearance, routine involvement of medical staff, and greater involvement for the woman in the decision-making process. Although all attributes were important to women, they were not all of equal importance. For example, if continuity of caregiver were achieved at the expense of decreasing the availability of pain relief then women would be worse off.Conclusions: The discrete choice experiment appears to be a useful tool in assessing the strength of women's preferences for different aspects of maternity care. Future research should include a qualitative approach to explore in greater depth the processes involved in shaping women's preferences.

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