title: The quality of childbirth care in China: women's voices: a qualitative study.
abstract: BACKGROUND
  In the context of improved utilisation of health care and outcomes, rapid socio-economic development and health system reform in China, it is timely to consider the quality of services. Data on quality of maternal health care as experienced by women is limited. This study explores women's expectations and experiences of the quality of childbirth care in rural China.
  
  
  METHODS
  Thirty five semi-structured interviews and five focus group discussions were conducted with 69 women who had delivered in the past 12 months in hospitals in a rural County in Anhui Province. Data were transcribed, translated and analysed using the framework approach.
  
  
  RESULTS
  Hospital delivery was preferred because it was considered safe. Home delivery was uncommon and unsupported by the health system. Expectations such as having skilled providers and privacy during childbirth were met. However, most women reported lack of cleanliness, companionship during labour, pain relief, and opportunity to participate in decision making as poor aspects of care. Absence of pain relief is one reason why women may opt for a caesarean section.
  
  
  CONCLUSIONS
  These findings illustrate that to improve quality of care it is crucial to build accountability and communication between providers, women and their families. Ensuring women's participation in decision making needs to be addressed.
authors.affiliation: Department for International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK. Joanna.raven@lstmed.ac.uk.
authors.forename: Joanna
authors.initials: J
authors.lastname: Raven
authors.affiliation: Centre of Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, UK. Nynke.vandenBroek@lstmed.ac.uk.
authors.forename: Nynke
authors.initials: N
authors.lastname: van den Broek
authors.affiliation: School of Public Health, Anhui Medical University, Hefei, China. fbtao@126.com.
authors.forename: Fangbiao
authors.initials: F
authors.lastname: Tao
authors.affiliation: School of Public Health, Anhui Medical University, Hefei, China. Wuweihk8028@163.com.
authors.forename: Huang
authors.initials: H
authors.lastname: Kun
authors.affiliation: Department for International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK. Rachel.tolhurst@lstmed.ac.uk.
authors.forename: Rachel
authors.initials: R
authors.lastname: Tolhurst
mesh_terms: D000328:Adult; D002681:China; D036861:Delivery, Obstetric / Q000523:psychology / Q000592:standards*; D005260:Female; D017144:Focus Groups; D006780:Hospitals, Rural / Q000592:standards*; D006801:Humans; D007407:Interviews as Topic; D008427:Maternal Health Services / Q000592:standards*; D017060:Patient Satisfaction; D011247:Pregnancy; D018907:Privacy; D036301:Qualitative Research; D011787:Quality of Health Care