Antenatal cardiotocography in primary midwife‐led care: Women's satisfaction

Neppelenbroek, Elise M.; Ammerlaan, Anouk J. M.; van der Heijden, Olivier W. H.; van der Pijl, Marit S. G.; Kaiser, Anouk; de Jonge, Ank; Verhoeven, Corine J. M.

Abstract

Background
In the Netherlands, antenatal cardiotocography (aCTG), used to assess fetal well-being, is performed in obstetrician-led care. To improve continuity of care, an innovation project was designed wherein primary care midwives perform aCTGs for specific indications. The aim of this study was to examine the satisfaction and experiences of pregnant women who received an aCTG in primary midwife-led care and explore which factors were associated with high satisfaction.

Methods
Data were collected through a self-administered questionnaire based on the Consumer Quality Index. The primary outcome was general satisfaction on a 10-point scale, with a score above nine indicating participants were “highly satisfied”.

Results
In total, 1227 women were included in the analysis. The study showed a mean general satisfaction score of 9.2. Most women were highly satisfied with receiving an aCTG in primary midwife-led care (77.4%). On the Consumer Quality Index, the mean satisfaction level varied from 3.98 (SD ± 0.11) for the subscale “client satisfaction” to 3.87 (SD ± 0.32) for the subscale “information provision” on a 4-point scale. Women at between 33 and 36 weeks' gestation were more likely to be highly satisfied (adjusted OR [aOR] = 3.35). Compared with a completely comfortable position during the aCTG, a mostly comfortable or somewhat comfortable level had decreased odds of being associated with a ranking of highly satisfied (aOR 0.24 and 0.19, respectively).

Conclusions
This study shows that pregnant women are satisfied with having an aCTG in midwife-led care. Providing aCTG in midwife-led care can increase access to continuity of care.

• Journal Article Type: Article
• Acceptance Date: Apr 27, 2023
• Online Publication Date: Jun 1, 2023
• Publication Date: 2023-12
• Deposit Date: Jun 7, 2023
• Publicly Available Date: Jun 8, 2023
• Journal: Birth
• Print ISSN: 0730-7659
• Electronic ISSN: 1523-536X
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 50
• Issue: 4
• Pages: 798-807
• DOI: https://doi.org/10.1111/birt.12725
• Keywords: tenatal cardiotocography, midwife-led care, satisfaction, value-based health care, women's experiences
• Public URL: https://nottingham-repository.worktribe.com/output/21378267
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1111/birt.12725