Quality and inequality in women's experiences of maternity care in Scotland: results of a national survey

The provision of high quality maternity care to women and babies is key to long term improvements in population health. However, within developed welfare systems some groups of mothers and babies still experience poorer care... [ view full abstract ]

The provision of high quality maternity care to women and babies is key to long term improvements in population health. However, within developed welfare systems some groups of mothers and babies still experience poorer care and worse outcomes.  This study aimed to explore how women’s experiences of maternity care in Scotland differ by physical and sociodemographic characteristics. 

Method

The study used data collected on 2,036 women who responded to the 2015 Scottish national maternity experience survey.   The analysis investigated whether experiences were dependent on age, parity, deprivation, rurality, general health and the presence of limiting health conditions.  Statistical outcomes were grouped relating to care processes and experiences and analysed using mixed effect multi-level models incorporating logistic regression.    

Key results

There was an association between parity, age, deprivation and time of booking indicating that younger women, women from more deprived areas and first time mothers book later.  Women with generally poorer health were more likely to experience poorer care in almost every domain including continuity, pain relief in labour, communication with staff, support and advice, involvement in care decision making, confidence and trust and overall rating of care.

Conclusions

We found few differences in maternity care experience for women based on activity limiting illness, age, deprivation, parity or geography. However, women who report having poorer general health had poorer experiences in every almost all aspects of care studied.  Our findings indicate that women most in need of care and support are less likely to receive it.