Women's care satisfaction and birth experiences in a Danish urban university hospital: A comparative cross-sectional study on midwifery-led continuity of care and standard midwifery care models.

Problem: Despite solid evidence and national recommendations supporting midwife-led continuity-of-care models, Danish women's access to such programs remains limited.

Background: A public birth facility introduced a midwife-led continuity-of-care model, targeting a subset of women receiving antenatal and intrapartum care.

Aim: To compare care satisfaction during pregnancy and birth and birth experience between women receiving midwife-led continuity of care and those receiving standard midwifery care.

Methods: This cross-sectional study used convenience sampling, with data collected via an online questionnaire distributed 4-6 weeks postpartum. Participants were recruited during antenatal visits. Birth experience and care satisfaction were assessed using the WOCCA and Pregnancy and Childbirth Questionnaires (PCQ). Domain scores of the PCQ were compared using linear regression to compare adjusted mean differences (aMD). Single items were compared with Mann-Whitney U-tests for non-normally distributed variables.

Findings: Between October 2022 and September 2023, 563 women were enrolled, with 368 responding. The midwife-led continuity of care group reported significantly higher satisfaction in both pregnancy domains than standard midwifery care (Personal Treatment: aMD 3.0 points; CI 1.7-4.3 and Education and Information: aMD 2.1 points; CI 0.9-3.3). Additionally, they reported a significantly more positive birth experience (p = 0.010), with 88.5 % (vs. 74.4 %) rating it very positive or outstanding. Also, overall care satisfaction during birth was higher, with 96.2 % (vs. 84.8 %) reporting being very or extremely satisfied (p = 0.021).

Conclusion: Women receiving midwife-led continuity of care reported more positive birth experiences and higher care satisfaction levels than women receiving standard midwifery care. The findings add to the evidence of the benefits of midwife-led continuity of care models. More comprehensive access to this model of care could enhance the pregnancy and birth experiences of more women, also in settings already offering midwifery-led care.