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Delivery practices and care experience during implementation of an adapted safe childbirth checklist and respectful care program in Chiapas, Mexico
Author(s) -
Molina Rose L.,
Villar Jimena,
Reyes Andrea,
Elliott James,
Begley Mark,
Johnson Mike,
Palazuelos Lindsay,
Montaño Mariana,
Flores Hugo,
Semrau Katherine E.A.,
Palazuelos Daniel
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12771
Subject(s) - medicine , childbirth , checklist , thematic analysis , nursing , family medicine , logistic regression , odds ratio , odds , obstetrics , qualitative research , pregnancy , psychology , social science , genetics , sociology , cognitive psychology , biology , pathology
Objective To evaluate changes in quality of care after implementing an adapted safe childbirth checklist ( SCC ) in Chiapas, Mexico. Methods A convergent mixed‐methods study was conducted among 447 women in labor who attended a rural community hospital between September 1, 2016, and June 30, 2017. Logistic regression analysis was used to evaluate adherence to evidence‐based practices over time, adjusting for provider. Participants were surveyed about their perceptions of care after hospital discharge. A purposefully sampled subgroup also completed in‐depth interviews. Thematic analysis was performed to evaluate perceptions of care. Results 384 (85.9%) women were attended by staff that used the adapted SCC during delivery. Of these, 221 and 28 completed the hospital discharge survey and in‐depth interview, respectively. Adherence with offering a birth companion (odds ratio [ OR ] 3.06, 95% CI 1.40–6.68), free choice of birth position (2.75, 1.21–6.26), and immediate skin‐to‐skin contact (4.53, 1.97–10.39) improved 6–8 months after implementation. Participants’ perceived quality of care improved over time. Provider communication generated positive perceptions. Reprimanding women for arriving in early labor or complaining of pain generated negative perceptions. Conclusion Use of the adapted SCC improved quality of care through increased adherence with essential and respectful delivery practices.