RESEARCH PAPER
Does financing for private maternity services improve birth experiences in Poland? A mixed-methods study of the Babies Born Better Survey
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1
Department of Gynecology and
Obstetrics Didactics, Medical
University of Warsaw, Warsaw,
Poland
2
Department of Midwifery,
Centre of Postgraduate Medical
Education, Warsaw, Poland
3
Department of Psychometry
and Statistics, Institute of
Psychology, University of Gdansk,
Gdansk, Poland
4
School of Nursing and
Midwifery, University of Central
Lancashire, Preston, United
Kingdom
Submission date: 2024-09-19
Final revision date: 2024-10-28
Acceptance date: 2024-10-28
Publication date: 2024-11-12
Corresponding author
Barbara Baranowska
Department
of Midwifery, Centre of
Postgraduate Medical Education,
Żelazna 90, 01-004, Warsaw,
Poland
Eur J Midwifery 2024;8(November):68
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Women in Poland, despite having access to publicly-funded medical
care during pregnancy, childbirth and the postpartum period, frequently use private care.
Women's experience and satisfaction with childbirth have been considered one of the
key indicators of the quality of care. In this study we explore whether and how paying
for private childbirth services affects women’s experiences and satisfaction with care.
The qualitative portion seeks to understand how individual women construct meaning
around their childbirth experiences, including their relationships with healthcare personnel,
medical interventions, birth environment, and professionalism.
Methods:
This mixed-methods study is based on data from 951 online questionnaires
completed by women who gave birth between June 2017 and June 2022, in Poland.
This study is part of the international Babies Born Better Survey project. The project
used simultaneous quantitative and qualitative data collection, it was exploratory with
equivalent status of qualitative and quantitative data. Quantitative data were analyzed
descriptively and chi-squared tests were conducted to compare women who used private
and public care. Qualitative data were analyzed using inductive thematic analysis. The
quantitative and qualitative results were integrated, in accordance with the chosen mixed-methods design.
Results:
There were no major differences in sociodemographic characteristics (except
living standards), health status and satisfaction with labor between women who paid
for private services during childbirth and those who used only publicly-funded care. For
both groups of women, healthcare personnel and their behavior were the most frequently
mentioned aspect shaping childbirth experiences. Other important aspects were: medical
interventions, birth environment, and staff professionalism.
Conclusions:
Although accessing private perinatal services care did not provide women
with care consistent with their expectations, women put a lot of trust into private services
as a means to receive more attentive care. Further research investigating the interplay
between private and public services is needed to explore the question how private services
may impact the care women receive and why women put so much trust in these services.
ACKNOWLEDGEMENTS
The work of all those who contributed to developing and running
the Babies Born Better Survey is acknowledged. Details of the
project, the Steering Group, and the Country Coordinators can be
found at: http://www.babiesbornbetter.org/about/.
CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form
for disclosure of Potential Conflicts of Interest and none was
reported.
FUNDING
This study was derived from the Babies Born Better project,
developed and supported as part of two EU COST Actions
(European Cooperation in Science and Technology Programme
as part of European Horizon 2020): 1) COST-Action IS0907:
Childbirth Cultures, Concerns, and Consequences: Creating a
dynamic European Union framework for optimal maternity care;
and 2) COST-Action IS1405: Building Intrapartum Research
Through Health – an interdisciplinary whole system approach to
understanding and contextualizing physiological labor and birth
(BIRTH).
ETHICAL APPROVAL AND INFORMED CONSENT
Ethical approval was obtained from the Ethics Committee of the
University of Central Lancashire (Approval number: STEMH 449;
Date: June 2020). Participants provided informed consent.
DATA AVAILABILITY
The data supporting this research are available from the authors
on reasonable request.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
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