Assessing the quality of midwifery care from the woman´s perspective

Background: Midwives provide comprehensive care for women giving birth. The care processes must be tailored to the needs of the women. Hence, woman-centred quality of care requires good process organization as well as high communicative and interactive skills. Furthermore, the woman's perspective is essential to assess the quality of care. For this reason, established assessment scales from health care were adapted to the context of midwifery care for the constructs Shared Decision Making (SDM-Q9-M) , Empathy (CARE-M) , Internal Team Participation (TEAM-M) , and Professional Competence (PC-M) . The aim of this study is to determine the psychometric properties of the assessment instruments in a sample of women. Methods: N = 201 women, who received midwifery care, completed the questionnaire as part of a cross-sectional survey. The unidimensional structure of the adapted single scales as well as the multidimensional structure of the entire assessment were analysed by means of confirmatory factor analysis (CFA). Results: Both for the single assessments (CFI ≥ .96; SRMR ≤ .032) and for the multidimensional model (CFI = .96; SRMR = .049) an appropriate to good model fit could be confirmed. Minor model modifications reflecting local item dependencies have to be regarded for the scales SDM-Q9-M , TEAM-M , and PC-M . For the CARE-M scale P articipatory Communication proved to be an independent structural component. Conclusions: To determine the quality of the midwifery care processes, an assessment is available that captures central components of woman-centred care from the perspective of woman. The assessment provides a validated basis for midwives to receive direct feedback on the quality of care and to evaluate woman-centred care.