Women's preferences for care delivery during labour and birth in Dutch hospitals: A Q-methodology study

Problem: Women's preferences regarding care delivery during labour and birth remain insufficiently understood. Obtaining a clear understanding of these is important to realise a maternity care system that is future-proof and person-centred. Background: Dutch maternity care deals with capacity issues due to staff shortages. Despite expected stable birth rates in the coming decades, this situation jeopardises the provision of care during labour and birth that is responsive to women's preferences. Aim: To systematically study a variety of women's preferences for care delivery during labour and birth in Dutch hospitals using Q-methodology. Methods: Q-methodology is a mixed methods approach. Thirty individual interviews were conducted with women living in the south-western Netherlands, during which they ranked 29 statements about their labour and birth preferences from least to most important. By-person factor analysis was performed to identify factors (viewpoints). Interpretation of the viewpoints was done using the qualitative interview data. Findings: Four viewpoints emerged from the study sample: 1) The personal approach, 2) The empowering approach, 3) The expert approach and 4) The needs-based approach. Consensus statements show a shared preference for respectful interaction. The study cohort emphasises continuity of adequate information provision, while continuity of care professional is deemed less important. Discussion: Our study was the first to apply Q-methodology to capture women's preferences for care delivery during labour and birth in Dutch hospitals. Although preferences are individual, they share commonalities in four viewpoints. Conclusion: The viewpoints provide valuable guidance for the allocation of scarce resources to ensure a maternity care system that is responsive to women's preferences.