Study & method | Preferences evaluated |
---|---|
Donaldson (1998) [19] Willingness to pay | Labour ward vs. midwives unit |
Labour ward characterised as: | |
- Doctors more likely to be involved in decision-making; midwives involved but women will not see the same midwife all the time; Electronic fetal monitoring; because of monitoring/other reasons 1 in 2 women have limitations on movement during labour; 1 in 12 women try alternative positions for delivery; 1 in 5 have an epidural; 1 in 3 have episiotomy | |
Midwives unit characterised as: | |
- Decisions made by women and midwives; most care from one midwife; traditional fetal monitoring, transfer to labour ward needed if continuous monitoring required; 1 in 4 women transferred to labour ward for electronic monitoring; because of monitoring/other reasons 1 in 3 have limitations on movement during labour; 1 in 8 try alternative positions for delivery; all types of pain relief available but transfer to labour ward required for epidural; 1 in 7 have an epidural; 1 in 4 have episiotomy | |
Emslie (1999) [21] Questionnaire survey - longitudinal follow-up | Features of place of birth rated by women at 14 and 36 weeks (selected list – not all reported) |
- Quiet atmosphere - Baby with you at all times - Availability of specialist facilities - Convenience for visitors - Choices in pain relief - Choices in delivery | |
Aspects of labour management rated by women (at 36 weeks): | |
- Partner being there - Availability of specialist staff/equipment - Being kept informed - Being involved in decisions - Time alone with partner - Choice of pain relief - Freedom to choose different positions - Handed baby immediately - Cared for by known staff - Not being left alone - Homely atmosphere - Cared for by named midwife - Being introduced to people - Provision of music/TV | |
Hundley (2004) [15], Hundley (2001) [16] Discrete choice experiment | Continuity (midwife): |
- Meet midwife antenatally, same midwife present throughout labour/birth vs. meet team of midwives antenatally, one present throughout labour/birth vs. previously unknown midwife but present throughout labour/birth vs. midwives working shifts may change during labour/birth | |
Pain relief: | |
- All methods except epidural vs. all methods available but epidural requires transfer vs. all methods available. | |
Fetal monitoring: | |
- Continuous, movement may be restricted during labour vs. intermittent unless complications develop, then continuous if required | |
Appearance of room: | |
- Homely vs. clinical appearance | |
Medical staff: | |
- Involved in care vs. only involved if complications develop | |
Decision-making: | |
- Staff make decisions vs. staff make decisions but keep woman informed vs. staff discuss things with women before deciding vs. staff give woman assessment, woman in control of decisions | |
Lavender (2005) [22] Questionnaire survey | Women were asked to state their level of agreement/disagreement with the following: |
- It is not important for me to have my baby in the same place as I receive antenatal care - It is important that my antenatal appointments are at a location close to where I live - I would be willing to travel if it meant I would receive higher quality care for my baby and me around the time of birth - It is important to me that a midwife helps me to give birth to my baby even if complications develop - I would feel unsafe if a specially trained doctor was not immediately available when I am in labour - It is not important to me that a midwife I know helps me to give birth to my baby - It is important to me to that [sic] a special care baby unit is in the same place that I give birth - It is important to me to be able to have an epidural at any time of day or night - It is important to me that a pool is available for my labour/birth - I want to be looked after by midwives and not have doctors involved - I would not want to transfer to a hospital a few miles away if my baby or I develop a problem | |
Longworth (2001) [18] Conjoint analysis | Continuity: |
- Have not met midwives prior to labour vs. have met midwives but don’t know them well vs. know midwives well | |
Location: | |
- Labour ward vs. maternity unit with a home-like environment vs. home | |
Pain relief: | |
- Gas & air/breathing only, no epidural, no birthing pool vs. gas & air and birthing pool, no epidural vs. all options including epidural | |
Decision-making during labour and delivery: | |
- Midwives and doctors will decide vs. decisions will be made jointly following discussion vs. woman will make own decisions | |
Probability of transfer to another hospital during labour: | |
- No need for transfer if problems develop vs. low probability of transfer vs. high probability of transfer | |
Pitchforth (2008) [20] Discrete choice experiment | Model of care: |
- Consultant-led vs. midwife-managed care - Pain relief: all methods available vs. no epidurala | |
Distance (‘time travelled’): | |
- Zero (home birth) vs. 30 mins vs. 60 mins vs. 90 mins vs. 120 mins | |
Rennie (1998) [23] Questionnaire survey | Aspects of intrapartum care rated by study participants: |
- Birth companion - Known midwife - In control - Few interventions - Able to do what you want - Same midwife in labour - Not to lose control of behaviour - Preferences and wishes followed - Attendance of midwife: - all the time vs. easy access vs. present only when I say - Information: - constant flow vs. staff to decide vs. only when asked for - Option for pain relief - pain-free with drugs vs. minimum drugs vs. drug free labour/other - Decision-making in labour: - staff decides vs. reach decision together vs. woman decides | |
Rogers (2011) [24] Questionnaire survey | Women who would use the local AMU when it becomes a stand-alone unit (FMU) were asked to select reasons for their choice: |
- Easy to get to - Physical environment - Previous bad experience - Previous good experience - Can use water in labour and for birth - Wants natural childbirth - Homely/small - Family can be involved - Other Women who would not use the local AMU when it becomes a stand-alone unit were asked to select reasons for their choice: | |
- Difficult to get to - Want an epidural - Feel safer - Previous bad experience - Previous good experience - Physical environment - Pressure from partner/family/friends - Would prefer a midwife-led unit on the same site as the hospital labour ward - Concern about transfer |