Satisfaction with maternity care: Psychosocial factors in pregnancy outcome

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Abstract
According to Ley (Ley and Spelman, 1967; Ley, 1977, 1982), dissatisfaction with medical communications and non-compliance with advice and instructions are caused by a failure to understand and remember what doctors say. The present experiment examines whether there might be additional factors, namely the attitudes and knowledge which people bring to the encounter. Seventy-three first-time parents-to-be were asked to complete attitude and knowledge questionnaires at the start of a six-week course of antenatal classes on parentcraft and again at the end. Satisfaction was measured in a further questionnaire after the birth, and the single most important predictor was found to be attitude: the more favourable the subject to medicine and hospital care, the greater the satisfaction with the classes and with outcome overall. Knowledge played no part. The next step for research, we argue, is to examine more closely the links between inputs and outputs - the processes which mediate between what the subject brings and the eventual outcome, whether psychological (including satisfaction) or physical (including the health of the mother and baby).

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