Intrapartum and postpartum care in Sweden:: women's opinions and risk factors for not being satisfied

Background. The aim of this study was to investigate satisfaction with intrapartum and postpartum care, and the risk of not being satisfied in relation to 1) a woman's sociodemographic background, 2) physical and emotional well-being in early pregnancy, 3) labor outcomes, 4) care organization, and 5) a woman's subjective assessment of aspects of care. Methods. All Swedish-speaking women booked for antenatal care during 3 weeks spread over 1 year (1999-2000) were invited to participate in the study, and 2,686 (82% of those who consented to participate and 58% of those who were eligible) completed questionnaires in early pregnancy and 2 months postpartum. Women who were satisfied with overall intrapartum. and postpartum care respectively were compared with those who were not regarding possible risk factors, and associations were tested by logistic regression analysis. Results. Ten percent of women were not satisfied with intrapartum care (ip) and 26% with postpartum care (pp). The following risk factors for not being satisfied were found: 1) age <25 years (ip), only elementary school (ip+pp), single status (pp), inconvenient timing of pregnancy (ip), lack of support from partner (ip); 2) suffering from many physical symptoms (ip+pp); 3) newborn transfer to neonatal clinic (ip + pp); 4) length of stay <1 day and >= 5 days (ip +pp), no "debriefing" after birth (ip), large hospital (pp); 5) lack of support by midwife (ip), little involvement in decision making (ip), dissatisfaction with birth environment (ip), insufficient time for breastfeeding support, encouragement and personal questions (pp).