title: User perspectives on the Swedish Maternal Health Care Register.
abstract: BACKGROUND
  Established in 1999, the Swedish Maternal Health Care Register (MHCR) collects data on pregnancy, birth, and the postpartum period for most pregnant women in Sweden. Antenatal care (ANC) midwives manually enter data into the Web-application that is designed for MHCR. The aim of this study was to investigate midwives' experiences, opinions and use of the MHCR.
  
  
  METHODS
  A national, cross-sectional, questionnaire survey, addressing all Swedish midwives working in ANC, was conducted January to March 2012. The questionnaire included demographic data, preformed statements with six response options ranging from zero to five (0 = totally disagree and 5 = totally agree), and opportunities to add information or further clarification in the form of free text comments. Parametric and non-parametric methods and logistic regression analyses were applied, and content analysis was used for free text comments.
  
  
  RESULTS
  The estimated response rate was 53.1%. Most participants were positive towards the Web-application and the included variables in the MHCR. Midwives exclusively engaged in patient-related work tasks perceived the register as burdensome (70.3%) and 44.2% questioned the benefit of the register. The corresponding figures for midwives also engaged in administrative supervision were 37.8% and 18.5%, respectively. Direct electronic transfer of data from the medical records to the MHCR was emphasised as significant future improvement. In addition, the midwives suggested that new variables of interest should be included in the MHCR - e.g., infertility, outcomes of previous pregnancy and birth, and complications of the index pregnancy.
  
  
  CONCLUSIONS
  In general, the MHCR was valued positively, although perceived as burdensome. Direct electronic transfer of data from the medical records to the MHCR is a prioritized issue to facilitate the working situation for midwives. Finally, the data suggest that the MHCR is an underused source for operational planning and quality assessment in local ANC centres.
authors.affiliation: Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden. kerstin.petersson@sodersjukhuset.se.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Petersson
authors.affiliation: Dalarna University, School of Health and Social Studies, Falun, Sweden. margareta.persson@umu.se.
authors.forename: Margareta
authors.initials: M
authors.lastname: Persson
authors.affiliation: Umeå School of Business and Economics, Department of Statistics, Umeå University, Umeå, Sweden. marie.lindkvist@stat.umu.se.
authors.forename: Marie
authors.initials: M
authors.lastname: Lindkvist
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. margareta.hammarstrom@vgregion.se.
authors.forename: Margareta
authors.initials: M
authors.lastname: Hammarström
authors.affiliation: Primary Health Care, Parental and Child Health Care, Östersund, Sweden. ingrid.haglund@jll.se.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Haglund
authors.affiliation: Department of Research and Development, Västernorrland County Council, Sundsvall, Sweden. karin.nilses@lvn.se.
authors.forename: Carin
authors.initials: C
authors.lastname: Nilses
authors.affiliation: Primary Health Care, Maternal Health Care Unit, Örebro, Sweden. yvonne.skogsdal@orebroll.se.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Skogsdal
authors.affiliation: Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden. ingrid.mogren@umu.se.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Mogren
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D000068097:Maternal Health; D008427:Maternal Health Services; D008499:Medical Records; D008875:Middle Aged; D008880:Midwifery; D036801:Parturition; D049590:Postpartum Period; D011247:Pregnancy; D037841:Pregnant People; D011295:Prenatal Care / Q000379:methods; D012042:Registries; D011795:Surveys and Questionnaires; D013548:Sweden