Experiences of maternity care in New South Wales among women with mental health conditions

Corscadden, L.; Callander, E. J.; Topp, S. M.; Watson, D. E.

doi:10.1186/s12884-020-02972-2

BMC Pregnancy and Childbirth

Table 4 Percentages, difference and adjusted odds of reporting positive experiences, women with compared to those without, a mental health condition

From: Experiences of maternity care in New South Wales among women with mental health conditions

Dimension	Stage	Question	Response	MHC (n)	MHC (%)	No MHC (%)	GAP	AOR	AOR 95% CI
Overall	1	#Overall, how would you rate the antenatal care you received during your pregnancy?	Very good	341	55	64	−9*	0.69	(0.51,0.94)
Overall	1	Were the health professionals providing your antenatal care polite and courteous?	Yes, always	345	84	90	−6	0.67	(0.43,1.05)
Overall	2	#Overall, how would you rate the care you received in the hospital during your labour and birth?	Very good	351	63	76	−13*	0.55	(0.4,0.76)
Overall	2	Were the midwives or doctors kind and caring towards you? [during labour and birth]	Yes, always	352	82	89	−7*	0.58	(0.39,0.86)
Overall	3	#Overall, how would you rate the care you received in the hospital after your baby was born?	Very good	350	52	60	−8*	0.72	(0.53,0.97)
Overall	3	If friends and family asked about your maternity experience at the hospital where you gave birth, how would you respond?	Would speak highly	352	70	81	−11*	0.57	(0.41,0.8)
Overall	3	After the birth of your baby, were the health professionals taking care of you kind and caring?	Yes, always	352	63	78	−14*	0.5	(0.36,0.7)
Overall	3	Looking back, do you feel that the length of your stay in hospital was …?	About right	352	71	84	− 13*	0.49	(0.34,0.69)
Overall	4	#Overall, how would you rate the care you received in the first two weeks after arriving home from the hospital?	Very good	353	60	68	−8	0.75	(0.55,1.02)
Emotional	1	(MH) Did the health professionals ask you how you were feeling emotionally during your pregnancy?	Yes	334	89	93	−4	0.67	(0.4,1.11)
Emotional	1	#Did the health professionals discuss your worries or fears with you? [at antenatal check-ups]	Yes, completely	240	54	65	−11*	0.67	(0.46,0.97)
Emotional	1	Did you have confidence and trust in the health professionals providing your antenatal care?	Yes, always	345	71	83	−11*	0.54	(0.39,0.76)
Emotional	2	#Did you have confidence and trust in the midwives or doctors taking care of you during your labour and birth?	Yes, always	352	76	88	−11*	0.48	(0.33,0.69)
Emotional	2	#Did a midwife or doctor discuss your worries or fears with you? [during labour and birth]	Yes, completely	214	48	63	−15*	0.54	(0.37,0.78)
Emotional	3	Shortly after the birth, did a health professional talk to you about how the birth had gone?	Yes	353	62	75	−13*	0.55	(0.41,0.76)
Emotional	4	(MH) During a follow-up appointment, did a midwife or nurse ask you how you were feeling emotionally?	Yes	337	97	98	−1	0.63	(0.29,1.39)
Information	1	(MH) Did the health professionals give you advice about the risks of consuming alcohol while pregnant?	Yes	324	91	89	2	1.19	(0.68,2.09)
Information	1	(MH) Did the health professionals give you advice about the risks of exposure to tobacco smoke while pregnant?	Yes	329	89	88	1	1.04	(0.61,1.75)
Information	1	(MH) Did the health professionals discuss the importance of healthy weight gain with you? [at antenatal check-ups]	Yes	321	75	80	−4	0.77	(0.53,1.11)
Information	1	#Did the health professionals providing your antenatal care explain things in a way you could understand?	Yes, always	346	73	85	−12*	0.51	(0.35,0.74)
Information	1	#Did you receive enough information about pain relief options prior to the birth?	Yes, definitely	314	48	62	−13*	0.58	(0.42,0.8)
Information	2	#During your labour and birth, did the midwives or doctors explain things in a way you could understand?	Yes, always	352	76	87	−11*	0.49	(0.34,0.71)
Information	3	#(MH) After the birth, did the health professionals give you enough information about how to care for yourself?	Yes, completely	344	42	57	−15*	0.56	(0.41,0.75)
Information	3	#After the birth of your baby, did the health professionals explain things in a way you could understand?	Yes, always	352	67	81	−14*	0.51	(0.37,0.71)
Information	3	After the birth, did the health professionals give you enough information about how to care for your baby?	Yes, completely	304	38	56	−18*	0.48	(0.35,0.66)
Information	3	Did midwives in the hospital work with you to show you a good position for breastfeeding your baby?	Yes	305	88	91	−3	0.74	(0.43,1.29)
Information	4	At any point during your pregnancy or after the birth, were you shown or given information about safe sleeping for your baby?	Yes	343	99	96	2*	2.69	(1.27,5.7)
Respect	2	#Were you involved, as much as you wanted to be, in decisions during your labour and birth?	Yes, definitely	346	67	73	−6	0.76	(0.56,1.04)
Respect	2	#Did you feel you were treated with respect and dignity during your labour and birth?	Yes, always	352	76	90	−14*	0.37	(0.25,0.54)
Respect	2	During your labour, were you able to move around and choose the position that made you most comfortable?	Yes, most of the time	280	60	67	−7*	0.7	(0.49,0.99)
Respect	2	Were you offered the option of being in a bath during labour?	Yes	226	50	53	−3	0.85	(0.58,1.25)
Respect	2	#Did you have enough say about your pain relief during your labour and birth?	Yes, definitely	351	61	71	−9*	0.66	(0.49,0.89)
Respect	2	Were you given enough privacy in the birth room or theatre?	Yes, always	351	84	90	−6*	0.62	(0.41,0.93)
Respect	2	Did you have skin to skin contact with your baby shortly after the birth?	Yes	308	97	96	0	1.04	(0.46,2.35)
Respect	3	#Did you feel involved in decisions about your discharge from hospital?	Yes, definitely	349	58	68	−10*	0.62	(0.46,0.85)
Respect	3	Were your decisions about how you wanted to feed your baby respected by the health professionals?	Yes, always	347	74	82	−7*	0.66	(0.46,0.95)
Respect	4	In general, did you feel that the midwife or nurse listened to you? [at follow-up appointment]	Yes, always	342	83	92	−9*	0.48	(0.31,0.74)
Respect	4	In general, did you have enough time with the midwife or nurse to ask questions or discuss any concerns? [at follow-up]	Yes, definitely	342	84	91	−7*	0.55	(0.35,0.86)
Involvement	2	During your labour and birth, was your birthing companion involved as much as they wanted to be?	Yes, definitely	347	79	88	−9*	0.56	(0.38,0.82)
Involvement	3	Were the visiting times convenient for your friends and family?	Yes, definitely	340	66	74	−8*	0.66	(0.47,0.92)
Comfort	2	Do you think the midwives or doctors did everything reasonable to help you manage your pain during your labour and birth?	Yes, definitely	350	66	77	−11*	0.57	(0.42,0.79)
Comfort	2	Were you able to get assistance from midwives or doctors when you needed it? [during labour and birth]	Yes, always	345	67	83	−16*	0.43	(0.31,0.61)
Comfort	3	#Do you think the health professionals did everything they could to help you manage your pain after the birth of your baby?	Yes, definitely	274	53	71	−18*	0.46	(0.33,0.65)
Comfort	3	After the birth of your baby, were you able to get assistance or advice from health professionals when you needed it?	Yes, always	351	54	70	−16*	0.51	(0.37,0.68)
Comfort	3	How clean were the wards or rooms you stayed in after the birth of your baby?	Very clean	350	63	70	−7*	0.7	(0.51,0.97)
Comfort	3	How clean were the toilets and bathrooms you used after the birth of your baby?	Very clean	351	60	67	−7*	0.69	(0.51,0.95)
Comfort	3	Bothered by noise, lack of privacy, lack of security or lighting during stay in hospital	Not bothered	349	38	44	−7*	0.71	(0.52,0.95)
Comfort	3	How would you rate the hospital food?	Very good	344	14	17	−3	0.78	(0.51,1.19)
Comfort	3	Did the hospital provide access to food when you needed it?	Yes, always	330	49	61	−12*	0.62	(0.46,0.85)
Coordination	1	#How well organised was the antenatal care you received at your check-ups?	Very well organised	345	50	58	−9*	0.71	(0.53,0.95)
Coordination	1	How many weeks pregnant were you when you had your first appointment for antenatal care?	Less than 14 weeks	339	43	40	3	1.16	(0.85,1.57)
Coordination	1	How much of this time did you usually spend waiting to be seen? [antenatal]	Under 30 min	345	54	55	−1	0.86	(0.64,1.16)
Coordination	1	Do you think the amount of time you waited was...? [antenatal]	About right	342	57	56	0	0.94	(0.69,1.27)
Coordination	1	Was there any time when the health professionals needed access to your medical history and it was not available? [antenatal]	No	344	67	75	−8*	0.66	(0.48,0.92)
Coordination	1	Were you provided with a personal antenatal card, where information about your antenatal check-ups was recorded?	Yes	339	94	96	−3	0.6	(0.31,1.15)
Coordination	1	Did the health professionals update your personal antenatal card at every check-up?	Yes	316	98	97	1	1.47	(0.76,2.85)
Coordination	2	#Did midwives or doctors ever give you conflicting information during your labour and birth?	No	351	79	82	−3	0.83	(0.56,1.22)
Coordination	2	Had you previously met any of the midwives or doctors who cared for you during your labour and birth?	Yes	348	49	49	0	0.92	(0.68,1.25)
Coordination	2	Did the midwives or doctors who you did not already know, introduce themselves to you during your labour and birth?	Yes, always	327	76	85	−9*	0.54	(0.37,0.79)
Coordination	3	#After the birth, did you ever receive conflicting information from health professionals about how to care for yourself/your baby?	No	353	62	69	−7	0.76	(0.56,1.03)
Coordination	3	Did you ever receive conflicting advice about feeding your baby from the health professionals?	No	346	57	69	−12*	0.64	(0.47,0.87)
Continuity	3	Before leaving hospital, were you given enough information about caring for yourself and your baby at home?	Yes, completely	335	45	64	−19*	0.45	(0.34,0.61)
Continuity	3	Did hospital staff tell you who to contact if you were worried about your health or your baby’s health after you left hospital?	Yes	335	93	95	−2	0.8	(0.41,1.56)
Continuity	4	In the first 2 weeks after arriving home, had a follow-up appointment with a midwife or nurse?	Yes at home	352	89	86	2	1.28	(0.85,1.93)

Adjusted Odds Ratio (AOR) of positive experience for women with compared without a mental health condition after adjusting for age, language, education, type of birth, parity, and local health district of residence are denoted by “*” where significant at p < 0.05. Stage 1: Antenatal, stage 2: Labour and birth, stage 3: hospital care following birth, stage 4: follow up care. Mental health condition group (MHC), no condition group (no MHC), Gap = percentage point difference MHC group minus no MHC group results based on unrounded values. Question text denoted by (MH) were questions identified as proxy measures related to guidelines for maternity care for women with mental illness, and those denoted by “#” are considered as more important measures of experience

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ISSN: 1471-2393

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