From the hospital organisation to the childbirth practice: Italian women’s experiences

Abstract

Objective: To compare the hospital management of childbirth with respect to women’s perception and satisfaction. Method: Semi-structured interviews were conducted with 20 first-time Italian mothers, who were recruited in the obstetrics and gynaecology operative unit of a large public hospital in Northern Italy during the 3 days following the births of their children. Data were electronically coded with ATLAS.ti software and a qualitative analysis was conducted. Women’s childbirth narrations were compared with the formal procedures stated in the corporate documents of the hospital. Results: Expectations, control-medicalisation, and the relationship with the caregivers were the main themes that emerged from the interviews. The women’s expectations were related to the hospital’s reputation, which centred on medical specialisation and humanisation. Their actual experiences were characterised by their trust for hospital staff and willingness to give up internal control in order to accept medical interventions. These factors were related to the external control that the women accepted in order to preserve their child’s and their own safety. Although the hospital organisational model was centred on the humanisation of care and patient-centred service, these directives did not correspond to the women’s actual experiences. Conclusions: Health services should take into account the consumers’ perspective and address personal agency in order to increase satisfaction and guarantee a more respectful childbirth care.

Keywords:

• childbirth
• health care system
• hospital organisation
• Italy
• qualitative analysis
• semi-structured interviews