title: Gaining insight into how women conceptualize satisfaction: Western Australian women's perception of their maternity care experiences.
abstract: BACKGROUND
  The concept of maternal satisfaction is challenging, as women's and clinicians' expectations and experiences can differ. Our aim was to investigate women's experiences of maternity care in an urban tertiary obstetric setting, to gain insight into conceptualization of satisfaction across the childbirth continuum.
  
  
  METHODS
  This mixed method study was conducted at a public maternity hospital in Western Australia. A questionnaire was sent to 733 women two weeks post birth, which included an invitation for an audio-recorded, telephone interview. Frequency distributions and univariate comparisons were employed for quantitative data. Thematic analysis of interview transcripts was undertaken to extract common themes.
  
  
  RESULTS
  A total of 54% (399 of 733) returned the questionnaire. Quantitative results indicated that women were less likely to feel: involved if they did not have a spontaneous vaginal birth (P = 0.020); supported by a midwife if they had a caesarean (P = <0.001); or supported by an obstetrician if they had a spontaneous vaginal birth (P = <0.001). Qualitative findings emerged from 63 interviews which highlighted the influence that organization of care, resources and facilities had on women's satisfaction. These paradigms unfolded as three broad themes constructed by four sub-themes, each illustrating a dichotomy of experiences. The first theme 'how care was provided' encompassed: familiar faces versus a different one every time and the best place to be as opposed to so disappointed. The second theme 'attributes of staff' included: above and beyond versus caring without caring and in good hands as opposed to handled incorrectly. The third theme 'engaged in care' incorporated: explained everything versus did not know why and had a choice as opposed to did not listen to my needs.
  
  
  CONCLUSIONS
  Quantitative analysis confirmed that the majority of women surveyed were satisfied. Mode of birth influenced women's perception of being involved with their birth. Being able to explore the diversity of women's experiences in relation to satisfaction with their maternity care in an urban, tertiary obstetric setting has offered greater insight into what women value: a sensitive, respectful, shared relationship with competent clinicians who recognise and strive to provide woman focused care across the childbirth continuum.
authors: School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, 6102, Western Australia, Australia. Lucy.lewis@curtin.edu.au.|Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia. Lucy.lewis@curtin.edu.au.
authors: Lucy
authors: L
authors: Lewis
authors: School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Perth, 6102, Western Australia, Australia. y.hauck@curtin.edu.au.|Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia. y.hauck@curtin.edu.au.
authors: Yvonne L
authors: YL
authors: Hauck
authors: Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia. Fiona.Ronchi@health.wa.gov.au.
authors: Fiona
authors: F
authors: Ronchi
authors: Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia. caroline.crichton@health.wa.gov.au.
authors: Caroline
authors: C
authors: Crichton
authors: Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Perth, 6008, Western Australia, Australia. Liana.Waller@health.wa.gov.au.
authors: Liana
authors: L
authors: Waller
mesh_terms: D000328:Adult; D003210:Concept Formation; D036861:Delivery, Obstetric / Q000379:methods / Q000523:psychology; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D008427:Maternal Health Services; D009035:Mothers / Q000523:psychology*; D017060:Patient Satisfaction; D011181:Postnatal Care / Q000523:psychology*; D011247:Pregnancy; D036301:Qualitative Research; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014904:Western Australia; D055815:Young Adult