Factors associated with women’s satisfaction with prenatal care in Porto Alegre, Rio Grande do Sul, Brazil

Paiz, Janini Cristina; Ziegelmann, Patrícia Klarmann; Martins, Ana Cláudia Magnus; Giugliani, Elsa Regina Justo; Giugliani, Camila

doi:10.1590/1413-81232021268.15302020

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ARTICLE • Ciênc. saúde coletiva 26 (08) • Aug 2021 • https://doi.org/10.1590/1413-81232021268.15302020 copy

Factors associated with women’s satisfaction with prenatal care in Porto Alegre, Rio Grande do Sul, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This article aims to identify factors associated with full satisfaction with prenatal care in health services in Porto Alegre (RS), Brazil. This is a cross-sectional study with 287 women that attended prenatal care in the state capital. Women were randomly selected at two large maternity hospitals (public and private) and interviewed at their homes around 30 days after delivery, from January to August 2016. Satisfaction was measured by a Likert scale (very satisfied to very unsatisfied). Prevalence ratios (PR) were estimated by Poisson regression with robust variance, using a hierarchical model. Factors associated with greater satisfaction were higher education (PR=1.49; 95% CI: 1.08-2.06); multiprofessional care (PR=1.29; 95% CI: 1.00-1.66); receiving information about breastfeeding (PR=1.33; 95% CI: 1.05-1.68) and place of delivery (PR=1.56; 95% CI: 1.12-2.17); and women feeling comfortable asking questions and participating in decisions (PR=5.17; 95% CI: 1.79-14.96). The findings suggest that prenatal care services that offer multiprofessional care, provide guidance, and make pregnant women feel comfortable asking and deciding about their care may generate greater satisfaction.

Key words:
Prenatal care; Women’s health; Patient satisfaction

Factors	Sample n(%)	Full satisfaction n(%)
Factors	n=287	Yes 133 (46,3%)	No 154 (53,7%)
Distal: sociodemographic
Age (years)
Mean + SD	29.1 (6.6)	30.3 (6.6)	28.0 (6.4)
≤ 19	23 (8.0)	8 (6.0)	15 (9.7)
20-34	199 (69.3)	84 (63.2)	115 (74.7)
≥35	65 (22.6)	41 (30.8)	24 (15.6)
Skin color
White	216 (75.3)	108 (81.2)	108 (70.1)
Black or brown	71 (24.7)	25 (18.8)	46 (29.9)
Socioeconomic level*
A - B	163 (57.2)	93 (70.5)	70 (45.8)
C - D - E	122 (42.8)	39 (29.5)	83 (54.2)
Schooling
Higher education (completed or incomplete)	124 (43.2)	78 (58.6)	46 (29.9)
Elementary and secondary school	163 (56.8)	55 (41.4)	108 (70.1)
Marital status*
Living with companion	188 (65.7)	100 (75.8)	88 (57.1)
Intermediate: obstetric history
Previous pregnancy
Yes	163 (56.8)	69 (51.9)	94 (61.0)
Planned pregnancy
Yes	154 (53.7)	83 (62.4)	71 (46.1)
Proximal: prenatal care
Type of service
Public	147 (51.2)	50 (37.6)	97 (63.0)
Private or mixed	140 (48.8)	83 (62.4)	57 (37.0)
Gestational age at onset (weeks)*
≤ 6**	102 (36.4)	58 (45.0)	44 (29.1)
7 over	178 (63.6)	71 (55.0)	107 (70.9)
Number of visits*
≤ 7**	46 (16.3)	13 (10.0)	33 (21.7)
8 and over	236 (83.7)	117 (90.0)	119 (78.3)
Multiprofessional care *
Yes	62 (21.7)	43 (32.3)	19 (12.4)
Sought information
Yes	221 (77.0)	109 (82.0)	112 (72.7)
Accompanied by the partner
Yes, at least in one visit	218 (76.0)	115 (86.5)	103 (66.9)
Informed about her rights*
Yes, fully	152 (53.9)	80 (61.5)	72 (47.4)
Informed about the place of delivery*
Yes	194 (67.8)	105 (78.9)	89 (58.2)
Informed about breastfeeding*
Yes, fully	88 (30.9)	55 (42.0)	33 (21.4)
No, or partially	197 (69.1)	76 (58.0)	121 (78.6)
Participated in a pregnant women’s group/course
Yes	52 (18.1)	27 (20.3)	25 (16.2)
Informed about birth plan*
Yes	37 (13.2)	23 (17.7)	14 (9.3)
Felt comfortable to ask
Yes, fully	241 (84.0)	130 (97.7)	111 (72.1)
No, or partially	46 (16.0)	3 (2.3)	43 (27.9)

Factors	Full satisfaction	PR_C	PR_A*
Factors	n (%)	(IC 95%)	(IC 95%)	P-value
Distal
Age (years)
Mean + SD	30.3 (6.6)	1.03 (1.01-1.05)	1.00 (0.97-1.02)	0.970
Skin color
White	108 (50.0)	1.42 (1.01-2.00)	1.09 (0.77-1.55)	0.596
Black or brown	25 (35.2)	1.00	1.00
Socioeconomic level
A - B	93 (57.1)	1.78 (1.33-2.39)	1.25 (0.87-1.82)	0.220
C - D - E	39 (32.0)	1.00	1.00
Schooling
Higher education (completed or incomplete)	78 (62.9)	1.86 (1.44-2.40)	1.49 (1.08-2.06)	0.015
Elementary and secondary school	55 (33.7)	1.00	1.00
Marital status
Living with companion	100 (53.2)	1.63 (1.19-2.23)	1.31 (0.92-1.86)	0.130
Without companion	32 (32.7)	1.00	1.00
Intermediate: Obstetric history
Previous pregnancy
Yes	69 (42.3)	0.82 (0.64-1.05)	0.90 (0.71-1.15)	0.418
No	64 (51.6)	1.00	1.00
Planned pregnancy
Yes	83 (53.9)	1.43 (1.10-1.86)	1.16 (0.88-1.53)	0.283
No	50 (37.6)	1.00	1.00
Proximal: prenatal care
Type of service
Public	50 (34.0)	0.57 (0.44-0.74)	1.02 (0.72-1.45)	0.904
Private or mixed	83 (59.3)	1.00	1.00
Gestational Age (weeks)
≤ 6	58 (56.9)	1.42 (1.11-1.82)	1.05 (0.83-1.34)	0.649
7 over	71 (39.9)	1.00	1.00
Number of visits
8 and over	117 (49.6)	1.75 (1.09-2.83)	1.12 (0.69-1.82)	0.643
≤ 7	13 (28.3)	1.00	1.00
Multiprofessional care
Yes	43 (69.4)	1.72 (1.37-2.17)	1.29 (1.00-1.66)	0.049
No	90 (40.2)	1.00	1.00
Sought information
Yes	109 (49.3)	1.35 (0.96-1.91)	1.27 (0.87-1.85)	0.201
No	24 (36.4)	1.00	1.00
Accompanied by the partner
Yes	115 (52.8)	2.02 (1.33-3.06)	1.37 (0.89-2.10)	0.143
No	18 (26.1)	1.00	1.00
Informed about rights
Yes, fully	80 (52.6)	1.36 (1.05-1.78)	1.07 (0.83-1.39)	0.577
No	50 (38.5)	1.00	1.00
Informed about the place of delivery
Yes	105 (54.1)	1.78 (1.27-2.48)	1.56 (1.12-2.17)	0.008
No	28 (30.4)	1.00	1.00
Informed about breastfeeding
Yes, fully	55 (62.5)	1.62 (1.27-2.04)	1.33 (1.05-1.68)	0.017
No, or partially	76 (38.6)	1.00	1.00
Informed about birth plan
Yes	23 (62.2)	2.10 (1.03-4.28)	0.89 (0.69-1.15)	0.378
No	107 (43.9)	1.00	1.00
Felt comfortable to ask
Yes, fully	130 (53.9)	8.29 (2.75-24.85)	5.17 (1.79-14.96)	0.002
No, or partially	3(6.5)	1.00	1.00

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[1] Collaborations

JC Paiz was responsible for the conception and design, analysis and interpretation of data, writing of the article and approval of the version to be published. PK Ziegelmann performed the data analysis and interpretation, critical review of the article and approval of the version to be published. ACM Martins and C Giugliani were responsible for the conception and design, analysis and interpretation of data, critical review of the article and approval of the version to be published. ERJ Giugliani was responsible for the conception and design, critical review of the article and approval of the version to be published.