[Pregnancy and delivery satisfaction of 424 patients in Perinatal Health Network « Sécurité Naissance ¼ of Pays-de-la-Loire area]. / Satisfaction de 424 usagers pendant la grossesse et à l'accouchement dans le Réseau de santé en périnatalité « Sécurité Naissance ¼ des Pays-de-la-Loire.

BACKGROUND: One method of evaluating a perinatal policy measuring user satisfaction is an important issue. The objective of the study was to measure satisfaction with the monitoring of pregnancy, childbirth and maternity stay. METHODS: Each volunteer maternity received a list of all births during one week in March-April 2008. The first mailing of questionnaires was conducted by post with stamped envelopes for the reply, after 2months in May and June 2008. A second reminder was made in July 2008. Responses to questions were coded using a Likert scale with four degrees with "very satisfied", "satisfied," "not very satisfied" and "not satisfied" with a quote by 4 to 1. The results are presented with the proportions of satisfied women, with radar diagrams. Transformation of responses with scores of 20 was established. RESULTS: In total, 424 responses were obtained in 22 maternities (/24), on 524 questionnaires sent (response rate 80.9 %). A comparison of mothers who responded to those who did not respond showed an over-representation of senior and middle managers and department. The average response time from birth was ten weeks±1 (8-26). The early prenatal care (known as the 4th month) was ignored (the word) by 58 % of women, but satisfying for those who have had while preparing for the birth, information on ultrasounds, tests on blood testing were satisfactory. A total of 13.2 % of women were hospitalized, and 94.9 % of cases, the information was obtained with 96.5 % satisfaction for the explanations. Mothers were met for the monitoring of pregnancy to 95.4 %. At delivery, the reception was well received with 94.7 % of satisfaction, like attention paid to patients with 93.5 % satisfied. The satisfaction score for delivery in general (with or without cesarean) was 16.5±4.0 (out of 20) with 92.5 % satisfied. The score for the cesarean section was 16.3 versus 16.6 for the low channels (not significant [NS]) in the case of anesthesia of 16.5 versus 16.7 (NS) in case of episiotomy of 15.9 versus 16.9 (P<0.05). The length of postpartum stay was found too short in case of 4.8 % (4.7 days), correct in 78.6 % (4.8 days), too long in 15.9 % (4.8 days). The satisfaction score for delivery in general (with or without cesarean) was 16.5 out of 20 with 92.5 % of satisfied. Also, 73.1 % of mothers tended to agree about the useful information for baby; 77.8 % thought that breastfeeding went well. The total score for pregnancy and childbirth is averaging 16.1, with 95.7 % of satisfied. The dissatisfying factors for 17 women have been linked in univariate to a department, the choice of maternity proximity and the existence of an episiotomy. Multivariate analysis was not significant criteria of discontent. CONCLUSION: Users respond to this type of investigation and seem satisfied with the care provided, in accordance with published data. The analysis of satisfaction and sources of dissatisfaction can improve treatments. The limits of the notion of satisfaction are analyzed.

[Duration of breastfeeding from 15 maternity wards of the perinatal network in the Pays de la Loire area]. / Durée d'allaitement maternel et facteurs de risques d'arrêt d'allaitement : évaluation dans 15 maternités du Réseau de santé en périnatalité des Pays de la Loire.

The "sécurité naissance - naître ensemble" network in the Pays de la Loire region of France, with 24 maternity units, conducted a survey of nursing women to determine the duration of breastfeeding and to study the factors influencing this practice. Phone calls were made to mothers at 1 month, 2 months, 3 months, and 6 months or until weaning. The statistical methods used were the Kaplan-Meier survival curve method with the calculation of the median duration of breastfeeding (exclusive or partial) in weeks, and the Cox multivariate model. The hazard ratio or relative risk (RR) was used in univariate analysis, and the adjusted odds ratio (aOR) in multivariate analysis (>1 related to short duration, and<1 related to long duration). Fifteen maternity units participated, and 239 women were followed. The median duration of breastfeeding was 15 weeks (3.5 months) with 10% discontinuing the first month and 25% continuing breastfeeding at 6 months. The final model of risk of duration contains the following variables: maternal age less than 30 years (aOR=1.54; 1.08-2.19), the time the decision was made before pregnancy (aOR=0.56; 0.38-0.83), BMI greater or equal to 30 (aOR=2.12 (1.18-3.79), and for the first month, the administration of bottle feeding or complements (aOR=2.51; 1.62-3.89), the baby's need to be stimulated to feed (aOR=5.07; 3.24-7.90), breastfeeding on demand (aOR=0.56; 0.39-0.82), and problems breastfeeding (aOR=1.45; 1.005-2.09). This survey to determine the duration of breastfeeding in western France, a region with low initiation rates, duration appears to be relatively long compared to other studies. The factors influencing breastfeeding duration were for some non-modifiable (age, time of the decision, etc.), and for others assistance by a professional (supplements, need for stimulation, difficulty sucking, breastfeeding on demand, etc.). Criteria for identifying difficulties are presented.