Figure 1.
Flowchart of the developmental process of the ReproQ.
Table 1.
Characteristics of the participating women in the preparatory interview study and the ReproQ survey study.
Table 2.
Exploratory factor analysis of the ReproQ (antenatal, delivery, and postpartum responses separately).
Figure 2.
Convergent validity: association between overall rating of maternity care, and ReproQ score (all domains combined).
Fig. 2A shows the results during the antenatal phase; Fig. 2B shows the results during labour and postnatal care. The overall rating (10-point VAS scale) was significantly associated with the overall ReproQ score (i.e. the unweighted summation [range 1–4] of the individual eight domains), in both the antepartum (p<0.001) and the postpartum phase (p<0.001).
Figure 3.
Discriminative validity: median domain-specific ReproQ-score, for antepartum and postpartum questionnaire.
The figure shows the median domain-specific ReproQ score for antepartum (A) and postpartum (P) questionnaire. The interquartile range of the domains are as follows: Dignity: 3.8–4.0 (A); 3.7–4.0 (P); Autonomy: 3.4–4.0 (A); 3.3–4.0 (P); Confidentiality 4.0–4.0 (A); 3.5–4.0 (P); Communication: 3.5–4.0 (A); 3.5–4.0 (P); Prompt Attention: 3.4–3.8 (A); 3.4–4.0 (P); Social Consideration: 3.0–4.0 (A); 3.4–4.0 (P); Basic Amenities 3.3–4.0 (A); 3.3–4.0 (P); Choice and Continuity: 2.9–4.0 (A); 3.1–4.0 (P). The average score combining all domains per individual has a median of 3.68 (IQR = 3.40–3.87) antepartum, and a median of 3.73 (IQR = 3.44–3.88) postpartum (p = 0.23). Domain-wise, Autonomy, Respect, Confidentiality were experienced better in pregnant women compared women who recently had given birth (p between 0.021 and <0.0001). Women who recently had given birth had better experiences with Prompt Attention, Social Consideration and Choice and Continuity (p between 0.033 and <0.0001).
Figure 4.
Discriminative validity: median domain-specific ReproQ-score according to perceived neonatal outcome and neonatal hospital admission.
The figure shows the median domain-specific ReproQ score for 4 groups: 1) women who did not perceive health problems with their baby and whose baby was not hospital-admitted (MD = 3.78, IQR = 3.52–3.87); 2) women who did not perceive health problems with their baby, but whose baby was hospital-admitted [e.g. for monitoring] (MD = 3.72, IQR = 3.45–3.85); 3) women who perceived health problems with their baby, but the baby was not hospital-admitted (MD = 3.47, IQR = 3.16–3.80); and 4) women who perceived health problems with their baby and whose baby was hospitalized (MD = 3.42, IQR = 3.10–3,72) (p>0.001). Note that the client's perception of neonatal outcome may differ from clinical judgement; here we assume the client's perspective to be primarily important.
Figure 5.
Discriminative validity: median domain-specific ReproQ-score according to integration level of care facilities.
The figures show the median domain-specific ReproQ score during the antenatal phase (5A) en during labour and postpartum care (5B), for women who received care in fully integrated organizations and for women who received care in less integrated organizations. These differences were not significant during antenatal care (p = 0.142), but were significant in care during labour and birth, and during postnatal care (p<0.001).