Women’s Suggestions Related to Experience of Care: Qualitative Study in Latvia Using WHO Standards as a Framework for Analysis

Objectives. Quality of maternal and newborn care (QMNC) is identified as a significant predictor of maternal and newborn health outcomes in the World Health Organization (WHO) policy framework and strategy for the European Region. As a result of the resonance in the public media with verbal and emotional abuse in recent years during childbirth, it is crucial to analyse and objectivise opinions and identify the factors that have led to this type of situation.
Materials and Methods. A qualitative study was conducted as part of IMAgiNE EURO project. 2079 women who gave birth in healthcare facilities in Latvia from March 1, 2020, to October 28, 2021, were included in the analysis and answered an online questionnaire based on WHO standards, including open-ended questions related to the experience of care during childbirth. One author independently used thematic analysis to analyse women’s comments, using the WHO Standards for improving QMNC as a framework for the analysis.
Results. Overall, 530 mothers commented on improving QMNC, and 33.58% (N = 178) women made 229 suggestions pertinent to the “experience of care”. The suggestions were divided into several groups, and the top five were: 1) increase empathy, emotional support, active listening, sensitive and respectful attitude (33.19% of suggestions, N = 76); 2) avoidance of verbal abuse, such as yelling, rudeness, ridicule, reproaches, talking behind the back (22.27%, N = 51); 3) the reasons of interventions and possible outcomes are clearly explained (21.40%, N = 49); 4) avoidance of express dissatisfaction with being disturbed or being asked for help (7.42%, N = 17); 5) improve effective communication, coordinated care and common views on the necessary actions among health professionals (3.93%, N = 9).
Conclusions. Key aspects of the experience of care can be defined as respectful and empathic behaviour, without passive-aggressive or aggressive humiliation of women, and improvements in these aspects would not leave women with traumatic birth experiences.