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RCOG World Congress 2023
June 12 - 14, 2023 | London, UK
EP.0802
Measuring “Women’s birthing experience using “Birth Satisfaction Scale revised
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Labour Ward Management
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MEASURING WOMEN’S BIRTHING EXPERIENCE USING “BIRTH SATISFACTION SCALE REVISED”
Dr. ANITA NELAKUDITI1Senior Consultant OBG, Department of Obstetrics and Gynecology, Aster Ramesh Hospitals , Guntur
BACKGROUND
Satisfaction is one of the most frequently reported outcome measures for quality of care. Assessment of satisfaction with maternity services is crucial. Views of women as consumers of maternity care are vital in improving services as maternity maters.
1.Birth satisfaction incorporates diversity in meaning and content. Being respected, in control & listened to, kind and respectful care constructs satisfaction—gives a good score reflecting good perinatal services.
2. Dissatisfaction reflects negative score thus giving us a scope for improvement of our perinatal services.
AIM & OBJECTIVE
To explore the prevalence of birth satisfaction in child bearing women undergoing natural birth in our institution using “Birth Satisfaction Scale” revised (3) as a measure of birth satisfaction a possible key performance indicator for our perinatal service delivery evaluation.
STUDY DESIGN—RANDOMIZED PROSPECTIVE OBSERVATIONAL STUDY METHODS
This project measures the patient related outcome of birth experience in women undergoing vaginal birth, using the “BIRTH SATISFACTION SCALE(REVISED)(2) - A 10 point questionnaire targeting satisfaction with labour & birth. From JULY-21—DECEMBER-22. A questionnaire BBS-R scale was given to women who have undergone natural birth and each question had a score from 0-4. The demographic details of the patient along with their party were also included. The results were analyzed statistically based on which the care given during antenatal and intrapartum period was improved.
The questions were grouped and analyzed based on
1) QUALITY OF CARE PROVISION - (BSSR-2,3,4,6) - defined by birth environment sufficient support, relationships with health care professionals.
2) PERSONAL ATTRIBUTES - (ability to cope during labour— BSSR - 1,8,9) - feeling in control, preparation for childbirth, relationship with baby.
3) STRESSED EXPERIENCE DURING LABOUR (BSSR-5,7,10) - Distress experienced during labour, obstetric injuries, perception of having received sufficient medical care, receipt of an obstetric intervention, pain experienced, long labour, health of baby.
RESULTS AND DISCUSSION
Analysis from (July 21 - February 22) - A total of 170 women with average age of participation - 20-36 years. Average duration of pregnancy - 37 weeks gestation, 91.7% were graduates, 55% were PRIMI gravidas & 44.75% were multiparous.
73.2% satisfaction pertaining to - Quality of care provision
40% satisfaction pertaining to - Women self assessed attributes
60.4% - had experienced less Stress experienced during labour.
It was observed that the satisfaction score was high regarding the quality of care of provision pertaining to cleanliness, hygiene and support from nurses and doctors. It was the psychological dimensions of satisfaction regarding women’s personal attribution and stress during labour which showed low scores. It was also observed that the Primi gravidas and those who required elective induction of labour owing to certain risk factors had more psychological stress and trauma during child birth.
As a women’s birth experience might influence her decision making regarding future pregnancies, medical and surgical intervention during child birth. We took preventive strategies to minimize impact of psychological trauma during the labour & birth
STRENGTHENING COMMUNICATION
- A separate counselor with communication sessions and antenatal classes regarding preparedness for labour and child birth from 28 weeks of gestation/ counselling regarding the advantages and side effects of labour.
- Involving the women to take part in decision making positively reinforcing in terms that they have choice and control over birthing.
- Involving partner (husband, mother)
- Increasing the nursing staff to patient ratio
- Counseling the nurses and training them regarding empathy towards the laboring women so that, she feels to being understood and listened to by the staff choice regarding labour analgesia.
Fab MOM Program, Antenatal birthing classes has been star ted fr om the month of February to edu- cate, counsel & prepare expecting and new mothers for natural birthing where trained female physio- therapist and Lamaze trainers were enrolled to support the expecting couples keeping COVID-19 in consideration giving online as well as physical - individual and group sessions.
To further improve quality aspects, we had enrolled to FOGSI - MANYATA program in the month of June, to empower our doctors, nursing and facility staff to handle complex deliveries and emergencies in a systematic way.
A total of 140 women from March 2022 - December 2022 with similar demographic data showed
88.1% - satisfaction pertaining to - Quality of care provision
95.25% - satisfaction pertaining to - Women self assessed attributes
76.23% - had experienced less stress experienced during labour
It was observed that the satisfaction score has significantly increased regarding women self assessed attributes and stress experienced during labour.
CONCLUSIONS
BSS-R appears to be a valid reliable multidimensional psychometric evidence based key performance indicator. The tool helped us to improve standards of care provision, identify aspects of birth dissatisfaction that may be remedied with good psychological care. Finding out more about what causes birth satisfaction/ dissatisfaction helped us to improve standards of antenatal and intrapartum care and allocate resources effectively. Improved perinatal services and good clinical nursing quality care should increase OPD Footfall and helpful in promotion of other departments of hospital resulting in further overall growth.
REFERENCES
- To view publications: http://researchrepository.napier.ac.uk/view/people/Hollins_Martin=3ACaroline_J=3A=3A.html https://protect-
eu.mimecast.com/s/JNnFCYMZyhAVPJ5TzfqKJ?domain=ichom.org/
- Measures of satisfaction with care during labour and birth: a comparative review | BMC Pregnancy and Childbirth | Full Text https:// bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-13-108
- BSS-R website: https://www.bss-r.co.uk www.ichom.org/medical-conditions/pregnancy-and-childbirth/
- A survey of women’s birth experiences using the Birth Satisfaction Scale–Revised Indicator (BSS-RI) - Indian J Obstet Gynecol Res - https://www.ijogr.org/article-details/13378
- Level of Maternal Satisfaction and its Determinants at Health Facilities in Mizan-Aman Town, Ethiopia: Cross Sectional Study https://