Satisfaction with the quality of early maternity care in the Czech Republic as seen by women - first quantitative results of the nationwide cross-sectional study

BACKGROUND: Women's perceptions of satisfaction with maternity care are an integral part of quality assessment in the context of perinatal outcomes in epidemiological data. We present the results of a nationwide project focused on women's satisfaction and experience with standard care covered by public health insurance in the Czech Republic. The aim is to describe the quality of maternity care as perceived by women, focusing on the information provided and the organisation of care. Based on the results, specific steps should be proposed to optimise the maternity care system in the Czech Republic. METHODS: National questionnaire analytical exploratory study (standardised PREMAPEQ instrument); assisted completion of the questionnaire by ten women; its adaptation according to differences in the national system of care and pilot testing; online data collection 2022 (N=1944); satisfaction rating: 5-point Likert scale; satisfaction clusters = average of responses to a given group of questions (converted to a scale 0-100); effect of sociodemographic characteristics on clusters determined by analysis of variance (ANOVA) with p=0.05; followed by Bonferroni correction for multiple testing and Games-Howell post-hoc tests. Effect size was assessed using Eta-squared for ANOVA results. RESULTS: Place of birth was associated with women's satisfaction in several areas, to the benefit of large obstetric facilities. Satisfaction of first-time mothers is significantly lower in many areas when compared to multiparous women. A high satisfaction level with the attitude of health professionals in labour wards was identified. A lower satisfaction level with the care organization was identified in postpartum wards. Low satisfaction with the information provided to women throughout all maternity care was found. The lowest satisfaction level was identified in the information about the woman's and baby's health status, care of the baby, and breastfeeding support. Key factors influencing women's experience and satisfaction with care in the Czech Republic include the attitude of health professionals, respect for the women's wishes, access to and sufficiency of information, the possibility of co-decision, choice, and the partner's presence during labour. CONCLUSIONS: The overall level of women's satisfaction with the care provided in the Czech Republic is relatively high, but there are areas where satisfaction lags behind expectations. Women's satisfaction with maternity care must be systematically monitored, and the findings of women's priorities must be continuously addressed.