Stephanie J Brown1, Georgina A Sutherland2, Jane M Gunn3, Jane S Yelland4. 1. Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia; General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Victoria 3053, Australia. Electronic address: stephanie.brown@mcri.edu.au. 2. School of Population and Global Health, University of Melbourne, Parkville, Victoria 3052, Australia. 3. General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Victoria 3053, Australia. 4. Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia.
Abstract
OBJECTIVE: to investigate women's views and experiences of public antenatal care. DESIGN: population-based survey in two states. SETTING: South Australia and Victoria, Australia. PARTICIPANTS: 4366 women surveyed at 5-6 months post partum. FINDINGS: of 8468 eligible women mailed the survey, 52% returned completed questionnaires. Fifty-seven per cent of women (2496/4339) received public antenatal care. Of these, half attended a GP for some/all antenatal visits, 38% attended a public hospital clinic or midwives clinic, and 12% had primary midwife care, mostly in a midwifery group practice. Women with complex needs - young women, those experiencing multiple social health problems, women of non-English speaking background, and women at higher risk of complications in pregnancy - were the least likely to say that care met their needs. Women attending a GP or midwife as a primary caregiver were the most positive about their antenatal care: 69% and 74% respectively describing their antenatal care as 'very good'. Women attending a standard public hospital clinic were the least positive about their antenatal care with only 48% rating their care as 'very good'. Women enroling in GP shared care or attending a midwives clinic at a public hospital gave intermediate ratings. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Models of public antenatal care involving a designated lead primary caregiver (GP or midwife) came closest to meeting women's need for information, individualised care and support.
OBJECTIVE: to investigate women's views and experiences of public antenatal care. DESIGN: population-based survey in two states. SETTING: South Australia and Victoria, Australia. PARTICIPANTS: 4366 women surveyed at 5-6 months post partum. FINDINGS: of 8468 eligible women mailed the survey, 52% returned completed questionnaires. Fifty-seven per cent of women (2496/4339) received public antenatal care. Of these, half attended a GP for some/all antenatal visits, 38% attended a public hospital clinic or midwives clinic, and 12% had primary midwife care, mostly in a midwifery group practice. Women with complex needs - young women, those experiencing multiple social health problems, women of non-English speaking background, and women at higher risk of complications in pregnancy - were the least likely to say that care met their needs. Women attending a GP or midwife as a primary caregiver were the most positive about their antenatal care: 69% and 74% respectively describing their antenatal care as 'very good'. Women attending a standard public hospital clinic were the least positive about their antenatal care with only 48% rating their care as 'very good'. Women enroling in GP shared care or attending a midwives clinic at a public hospital gave intermediate ratings. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Models of public antenatal care involving a designated lead primary caregiver (GP or midwife) came closest to meeting women's need for information, individualised care and support.