PT - JOURNAL ARTICLE AU - Marzia Lazzerini AU - Ilaria Mariani AU - Chiara Semenzato AU - Emanuelle Pessa Valente TI - Association between maternal satisfaction and other indicators of quality of care at childbirth: a cross-sectional study based on the WHO standards AID - 10.1136/bmjopen-2020-037063 DP - 2020 Sep 01 TA - BMJ Open PG - e037063 VI - 10 IP - 9 4099 - http://bmjopen.bmj.com/content/10/9/e037063.short 4100 - http://bmjopen.bmj.com/content/10/9/e037063.full SO - BMJ Open2020 Sep 01; 10 AB - Objectives This study aimed to explore the association between maternal satisfaction and other indicators of quality of care (QoC) at childbirth, as defined by WHO standards.Design Cross-sectional study.Setting Referral hospital in Northeast Italy.Participants 1244 consecutive mothers giving birth in the hospital participated in a survey.Data collection and analysis Univariate analyses were performed to evaluate the association between maternal satisfaction and 61 variables, including measures of ‘provision of care’, ‘experience of care’, ‘availability of resources’ and other maternal characteristics. Exploratory factor analysis was performed to create groups of correlated variables, which were used in multivariate analysis.Results Overall, 509 (40.9%) of women were >35 years of age, about half (52.7%) were highly educated, most (95.2%) were married/living with partner and employed (79.3%) and about half (52.9%) were primiparous. Overall, 189 (15.2%) were not born in Italy and 111 (8.9%) did not have Italian citizenship. Most women (84.2%) were highly satisfied (score ≥7/10) with the care received. Among the 61 variables explored, 46 (75.4%) were significantly associated with women’s satisfaction, 33 with higher satisfaction and 13 with lower satisfaction. Multivariate analysis largely confirmed univariate findings, with six out of eight groups of correlated variables being statistically significantly associated with women’s satisfaction. Factors most strongly associated with women’s satisfaction were ‘effective communication, involvement, listening to women’s needs, respectful and timely care’ (OR 16.84, 95% CI 9.90 to 28.61, p<0.001) and ‘physical structure’ (OR 6.51, 95% CI 4.08 to 10.40, p<0.001). Additionally, ‘victim of abuse, discrimination, aggressiveness’ was inversely associated with the wish to return to the facility or to recommend it to a friend (OR 0.35, 95% CI 0.17 to 0.70, p<0.003).Conclusion This study suggested that many variables are strongly associated with women’s satisfaction with care during childbirth and support the use of multiple measures to monitor the QoC at childbirth.