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Satisfaction and the three C's: continuity, choice and control. Women's views from a randomised controlled trial of midwife-led care
Article first published online: 19 AUG 2005
DOI: 10.1111/j.1471-0528.1997.tb10974.x
Issue
1471-0528/asset/cover.gif?v=1&s=b4e1d96c46e18c61210d584b63c13ee375cf562b "BJOG: An International Journal of Obstetrics & Gynaecology")
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 104, Issue 11, pages 1273–1280, November 1997
Additional Information
How to Cite
Hundley, V. A., Milne, J. M., Glazener, C. M. A. and Mollison, J. (1997), Satisfaction and the three C's: continuity, choice and control. Women's views from a randomised controlled trial of midwife-led care. BJOG: An International Journal of Obstetrics & Gynaecology, 104: 1273–1280. doi: 10.1111/j.1471-0528.1997.tb10974.x
Publication History
- Issue published online: 19 AUG 2005
- Article first published online: 19 AUG 2005
- Received 20 June 1996 Returned for revision 24 October 1996 & 17 April 1997 Revised versions received 17 January 1997 & 16 May 1997 Accepted 9 June 1997
- Abstract
- Article
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Objective 1. To explore whether there are differences in women's satisfaction with care in a midwife-managed delivery unit compared with that in a consultant-led labour ward. 2. To compare factors relating to continuity, choice and control between the two randomised groups.
Design A pragmatic randomised controlled trial.
Setting Aberdeen Maternity Hospital, Grampian.
Sample 2844 women, identified at booking as low risk, were randomised in a 2:1 ratio between the midwives’ unit and the labour ward.
Main outcome measures Satisfaction, continuity of carer, choice, and control.
Results Satisfaction with the overall experience did not differ between the groups. Satisfaction with how labour and delivery was managed by staff was slightly higher in the midwives’ unit group, but this did not reach the 0.1% level of significance. Women allocated to the midwives’ unit group saw significantly fewer medical staff and were less likely to report numerous individuals entering the room. They were more likely to report having had a choice regarding mobility and alternative positions for delivery and were significantly more likely to have made their own decisions regarding pain relief.
Conclusions The issues surrounding the measurement of satisfaction with childbirth need further investigation. Until this area is clarified it would be unwise to use an overall measure of satisfaction as an indicator of the quality of maternity service provision. In particular, the current measures are not sensitive enough to examine the specific factors which affect women's satisfaction. Further research is required to assess which factors are important to women if they are to have a positive experience of childbirth and how these priorities change over time.