Women's dissatisfaction with inappropriate behavior by health care workers during childbirth care in France: A survey study.


Collaborators: Battut A, Cloudstone A, Gerentes C, Martinez N, Pinceloup C, Cosset M, Favre S, Dolezon D, Boudet C, Romegoux P, Aboubi C, Benoit L, Gherici N, Payan F, Poulet E, Bonnefond A, Riffard A, Almodovar A, Roch N, Goubault J, Morgan C, Gomart C, Pollet E, Silvestre MA, Tonda J, Gindre M, Haegenaer C, Ruat N, Bouty F, Andre C, Blanc J, Facchin F, Senghor M, Bonjean SL, Costa M, Delon P, Douet A, Fabre S, Lopez A, Pinget C, Blanc E, Caudevelle S, Lafuente M, Levrat C, Maiga G, Schwich D, Taillieu L, Coche S, Corgnet N, Desparain B, Lasfer N, Perrin S, Rolin C, Louet C, Sanlaville AD, Large D, Rome-Esteoule I, Escolano CI, Digarcher M, Gonnon A, Luquet F, Burnier C, Guerin M, Mely F.
Author information:
(1)Hôpital Femme - Mère-Enfant, Hospices Civils de Lyon, Bron, France.
(2)Research on Healthcare Performance
(RESHAPE), Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France.
(3)Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland.
(4)Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France.
(5)Inserm U846, Stem Cell and Brain Research Institute, Bron, France.
(6)Réseau Périnatal AURORE, Lyon, France.
(7)CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France.
(8)Inserm U1032, Laboratory of Therapeutic Applications of Ultrasound, Lyon, France.
(9)Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France.


BACKGROUND: Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and behavior. Few studies have examined the proportion of women in Western countries expressing dissatisfaction with such inappropriate or inconsiderate behavior. This study evaluated this proportion in a sample presumably representative of French maternity units. METHODS: This prospective multicenter study, using data from a selfadministered questionnaire, took place in 25 French maternity units during one week in September 2018. The primary outcome measure was mothers' self-reported dissatisfaction with blatantly inappropriate behavior (ie, inappropriate attitude, inadequate respect for privacy, insufficient gentleness of care, and/or inappropriate language) by health care workers in the delivery room. The secondary outcome was their self-reported dissatisfaction with these workers' inconsiderate behavior (ie, unclear and inappropriate information, insufficient participation in decision-making, or deficient consideration of pain). RESULTS: Of 803 potentially eligible women, 627 completed the questionnaire after childbirth; 5.62% (35/623, 95% CI: 3.94-7.73) reported dissatisfaction with blatantly inappropriate behaviors and 9.79% (61/623, 95% CI: 7.57-12.40) with inconsiderate behaviors. The main causes of dissatisfaction reported by women in this survey were the inadequate consideration of their pain and the failure to share decision-making. CONCLUSIONS: Most of the women were satisfied with how health care workers behaved towards them in the delivery room. Nonetheless, health care staff must be aware of women's demands for greater consideration of their expressions of pain and of their voice in decisions.