Young Kate, Miller Yvette D
School of Public Health & Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
Birth. 2024 Mar;51(1):71-80. doi: 10.1111/birt.12762. Epub 2023 Aug 25.
Woman-centered maternity service delivery is endorsed by Australian federal health policy. Despite this, little evaluation of maternity care is conducted through the lens of women. We examined the responses of women birthing in Australia to the international Babies Born Better 2018 (Version 2) open-response survey.
An online international survey was distributed primarily by means of social media for women who had given birth in the last 5 years. In addition to closed-ended questions to describe the sample, a series of open-ended questions recorded women's experiences and satisfaction with their maternity care and place of birth.
Of 1249 women who reported birthing their most recent baby in Australia and speaking English, 84% responded to at least one open-ended evaluation question. We thematically analyzed the data to identify three related themes of safety, choice, and respect for women. Women's experiences of these were closely tied to their model of care; those birthing at home with a private midwife more so reported positive experiences than those discussing obstetric care or, to a lesser extent, midwifery-led care in a hospital. There was a strong preference and need for (1) access to affordable care with a known practitioner from early pregnancy to postpartum, and (2) individualized care with the removal of restrictive hospital policies not aligned with woman-centered practice.
This is the first Australian national study of women's maternity experiences and evaluations. Consistent with previous state-based research, women birthing in Australia continue to report maternity "care" that is physically and emotionally harmful. They also stated a need to address the psychosocial aspects of becoming a mother, in addition to the biological ones. Women and other birthing people must be at the center of defining quality maternity health service delivery, and services must be accountable for preventing and addressing harm, as defined by all birthing people.
以女性为中心的孕产妇服务提供得到了澳大利亚联邦卫生政策的认可。尽管如此，很少从女性的角度对孕产妇护理进行评估。我们调查了在澳大利亚分娩的女性对2018年国际“更好出生的婴儿”（第2版）开放式调查问卷的回答。
一项在线国际调查主要通过社交媒体分发给过去5年内分娩的女性。除了用于描述样本的封闭式问题外，一系列开放式问题记录了女性对其孕产妇护理和分娩地点的经历及满意度。
在1249名报告在澳大利亚分娩其最近一个婴儿且说英语的女性中，84%至少回答了一个开放式评估问题。我们对数据进行了主题分析，以确定安全、选择和对女性的尊重这三个相关主题。女性在这些方面的经历与她们的护理模式密切相关；与那些在医院讨论产科护理或在较小程度上讨论由助产士主导的护理的女性相比，在家中由私人助产士接生的女性更多地报告了积极的经历。对于（1）从早孕到产后能接触到熟悉的从业者提供可负担得起的护理，以及（2）去除与以女性为中心的做法不一致的限制性医院政策的个性化护理，有强烈的偏好和需求。
这是澳大利亚第一项关于女性孕产妇经历和评估的全国性研究。与之前基于州的研究一致，在澳大利亚分娩的女性继续报告称孕产妇“护理”在身体和情感上具有伤害性。她们还表示，除了生理方面，还需要关注成为母亲的心理社会方面。女性和其他分娩者必须处于界定高质量孕产妇健康服务提供的核心位置，并且服务必须对预防和解决所有分娩者所定义的伤害负责。
