Client experiences with perinatal healthcare for high-risk and low-risk women

Problem: It is unknown if client experiences with perinatal healthcare differ between low-risk and high-risk women. Background: In the Netherlands, risk selection divides pregnant women into low-and high-risk groups. Receiving news that a pregnancy or childbirth has an increased likelihood of complications can cause elevated levels of emotional distress. Aim: The purpose of this study is to describe client experiences with perinatal healthcare and to determine which, if any, background characteristics, pregnancy circumstances, childbirth or follow-up care characteristics are explaining variables of differences in client experiences between high-risk and low-risk women. Methods: Client experiences were measured with a validated questionnaire completed by 1388 women within 12 weeks after childbirth. Findings: Women rated their experiences with perinatal healthcare with a mean score of 3.78 on a scale of 1-4; 5.5% of the women rated their experiences as "notably bad". Client experiences with perinatal healthcare show small variations, with a lower mean score for women who were at high risk (3.75) compared to low-risk women (3.84). This difference is partially due to more unplanned medical interventions and pain relief during childbirth in the high-risk group. Also, single mothers and non-Dutch women were more susceptible to less positive experiences. Conclusion: Given the potential negative impact of adverse client experiences, this study highlights the need for healthcare professionals to be aware of what women are susceptible for having had negative experiences. It is advised that healthcare provision be altered to tailor to the needs of these women. (c) 2018 The Authors. Published by Elsevier Ltd on behalf of Australian College of Midwives. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).