SATISFACTION WITH MIDWIFE-MANAGED CARE IN DIFFERENT TIME PERIODS - A RANDOMIZED CONTROLLED TRIAL OF 1299 WOMEN

Objective: to compare women's satisfaction with midwife-managed care w ith 'shared care' over three different time periods. Design: randomise d controlled trial. Setting: Glasgow Royal Maternity Hospital, Glasgow , UK, Participants: 1299 women experiencing normal pregnancy(consent r ate: 82%). Six hundred and forty-eight women were randomised to midwif e-managed care and 651 to 'shared care'. Methods: three self-report qu estionnaires were sent to women's homes. The questionnaires examined: satisfaction with antenatal care at 34-35 weeks' gestation, and satisf action with intrapartum, hospital- and home-based postnatal care at se ven weeks postnatally, The third questionnaire reviewed satisfaction w ith intrapartum care seven months after delivery. Findings: women in b oth groups were satisfied. However, women in the midwife-managed group were more highly satisfied in relation to the dimensions examined: re lationships with staff, information transfer, choices and decisions, a nd social support. The differences between the two groups were evident for all time periods (i.e. antenatal, intrapartum and postnatal perio ds) and were sustained at seven-month follow-up. This is illustrated i n the mean scores for relationships with staff, as measured at 34-35 w eeks' gestation (possible range -2; very negative attitudes to 2; very positive attitudes). Women in the midwife-managed group scored a mean of 1.22 compared to 0.74 for the 'shared care' group (mean diff: 0.48 ; 95% CI: 0.42 to 0.55). While women in both groups were more likely t o make positive rather than negative comments in open-ended questions, the midwife-managed group were more likely to make positive comments whereas the 'shared care' group were more likely to make negative comm ents. Conclusion: midwife-managed care for healthy pregnant women whic h is integrated into existing services improves satisfaction with ante natal, intrapartum and postnatal care.