title: Shortcomings of maternity care in Serbia.
abstract: BACKGROUND
  Maternity care in Serbia is an integrated part of the centralized health care system inherited from the former Yugoslavia. Childbirth is often perceived as a medical event instead of a physiological process. This paper examines quality and access indicators, and patient payments for maternity care in Serbia.
  
  
  METHODS
  We apply a method of triangulation using data collected through three sources: online questionnaires filled in by mothers who delivered in one of the maternity wards in Serbia in the period 2000-2008, research publications, and official guidelines. To compare the qualitative data from all three sources, we apply framework analysis.
  
  
  RESULTS
  The results show a good network of maternity wards in Serbia. On the other hand, many women who gave birth in maternity wards in Serbia indicate problems with the treatment they received. The existence of informal patient payments and so-called "special connections" make the position of Serbian women in maternity wards vulnerable, especially when they have neither connections nor the ability to pay. Poor communication and bedside manner of medical staff (obstetricians, other physicians, midwives, and nurses) during the birth process are also frequently reported.
  
  
  CONCLUSIONS
  Actions should be taken to improve bedside manners of medical staff. In addition, the government should consider the involvement of private practitioners paid by the national insurance fund to create competition and decrease the need for informal payments and "connections."
authors.affiliation: Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, The Netherlands.
authors.forename: Jelena
authors.initials: J
authors.lastname: Arsenijevic
authors.forename: Milena
authors.initials: M
authors.lastname: Pavlova
authors.forename: Wim
authors.initials: W
authors.lastname: Groot
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D005382:Financing, Personal; D006297:Health Services Accessibility; D006801:Humans; D008427:Maternal Health Services / Q000191:economics / Q000592:standards*; D009774:Obstetrics / Q000592:standards*; D011247:Pregnancy; D011369:Professional-Patient Relations; D011787:Quality of Health Care; D055771:Serbia
keywords: Serbia; childbirth; maternity care