| Description |
The characteristics that enhance client satisfaction at a freestanding birth center with certified nurse-midwives (CNMs) were explored. Eighty eight total births occurred during the time frame studied and were examined for length of stay and birth/newborn events. Thirty three of the 88 clients were located for a survey consisting of 16 items measured on a Likert scale and open ended questions. Stat80 was used to generate descriptive statistics from quantitative data. One woman was transferred to the hospital; therefore, some questions were not applicable. Another's baby was also transferred and her comments were analyzed on an individual basis. The women's average age was 27 years. Twenty six women (30%) were primiparas, and 62 (70%) were multiparas. The average infant birth weight was seven pounds five ounces, and the mean APGAR Scores at one and five minutes were 7.7 and 8.9, respectively. Total time in the birth center (admission to discharge) averaged 16 hours and 11 minutes. Twenty three (72%) women stated their postpartum length of stay was about right, and nine (28%) women felt it was too short, although they actually stayed longer than women stating the stay was about right. None stated the stay was too long. Total average response score for all 16 items on the seven point Likert scale was 6.65. Highest scores were given to areas of physical environment, nurse-midwifery and nursing care and knowledge. Lowest scores pertained; to food services. Specific comments on clients' likes of the birth experience included peaceful and private environment and individual, supportive, and personal care. Many stated they liked having more control over their birth experience i. e., having more choices about their care such as choosing pushing and laboring positions and also keeping their baby with them all of the time. The women also shared dislikes. Environmental dislikes included a bed and rocking chair that were uncomfortable, and allowing too many phone calls and visitors in the room after delivery. Other dislikes included not having a familiar CNM for delivery, not enough or variety of foods offered, too short postpartum stays, and billing problems. Suggestions for improvement included having the same CNM for delivery, increasing billing staff, increasing quantity and variety of food, and increasing postpartum length of stay. Women who had birth experiences elsewhere stated in comparison to other birth centers, this experience was comparable. All, but one woman whose baby was transferred to the hospital, stated their birth center experience was much better than the hospital. All, but the woman whose baby was transferred, stated they would utilize the birth center again and would recommend it to a relative or friend. In summary, the data indicate that physical environment, nurse-midwifery care, and the sense of control at the birth center are the main characteristics contributing to and enhancing client satisfaction with their birth experience. Areas of dislikes and needing improvements targeted general environmental issues, choice of CNM at delivery, and food services. All, but one woman, agreed that delivering at a birth center was much better than a hospital, and they would recommend it to others. Overall, the data indicate that the women viewed the birth center as a safe, highly valued, and satisfying alternative to hospital births. |
