Women’s dissatisfaction with inappropriate behavior by health care workers during childbirth care in France: A survey study

Abstract

Background Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and behavior. Few studies have examined the proportion of women in Western countries expressing dissatisfaction with such inappropriate or inconsiderate behavior. This study evaluated this proportion in a sample presumably representative of French maternity units. Methods This prospective multicenter study, using data from a selfadministered questionnaire, took place in 25 French maternity units during one week in September 2018. The primary outcome measure was mothers' self‐reported dissatisfaction with blatantly inappropriate behavior (ie, inappropriate attitude, inadequate respect for privacy, insufficient gentleness of care, and/or inappropriate language) by health care workers in the delivery room. The secondary outcome was their self‐reported dissatisfaction with these workers' inconsiderate behavior (ie, unclear and inappropriate information, insufficient participation in decision‐making, or deficient consideration of pain). Results Of 803 potentially eligible women, 627 completed the questionnaire after childbirth; 5.62% (35/623, 95% CI: 3.94‐7.73) reported dissatisfaction with blatantly inappropriate behaviors and 9.79% (61/623, 95% CI: 7.57‐12.40) with inconsiderate behaviors. The main causes of dissatisfaction reported by women in this survey were the inadequate consideration of their pain and the failure to share decision‐making. Conclusions Most of the women were satisfied with how health care workers behaved towards them in the delivery room. Nonetheless, health care staff must be aware of women's demands for greater consideration of their expressions of pain and of their voice in decisions.

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“…For many women the birth had also taken place more than one year ago. Whilst a study using Salmon’s Item List has shown that measures of overall satisfaction with childbirth can be quite stable, at least until the second year after childbirth [ 19 ], it has also been argued that assessments of childbirth may come “too soon” [ 20 ].…”

Birth plans : Developing a shared medical decision aid tool

“…Women should be better prepared by health carers to the experience of pain during childbirth (45,46). This is even more important as a recent study showed that the main source of mothers' dissatisfaction with the behavior of carers was their lack of consideration for their pain during labour (47).…”

Disrespect during childbirth and postpartum mental health: a French cohort study

“…attitude, respect for privacy, language, and/or gentleness of care and procedures, information provided, women’s participation in decision-making, and/or consideration of pain). As the French National Academy of Medicine suggests, if one of these dimensions is reported as disrespectful by the mother, then it is considered that the mother is victim of disrespect [ 4 , 5 ]. It was adopted and validated in French language by the AURORE network (Cronbach’s alpha 0.92) [ 5 ].…”

“…As the French National Academy of Medicine suggests, if one of these dimensions is reported as disrespectful by the mother, then it is considered that the mother is victim of disrespect [ 4 , 5 ]. It was adopted and validated in French language by the AURORE network (Cronbach’s alpha 0.92) [ 5 ]. This measure was taken at 3 days postpartum.…”

“…The French National Academy of Medicine distinguishes 7 dimensions of disrespect during childbirth (i.e. attitude, respect for privacy, language, and/or gentleness of care and procedures, information provided, women’s participation in decision-making, and/or consideration of pain) [ 4 , 5 ].…”