Future directions for Victoria's public maternity services: is this "what women want"?

Abstract

Background: Several state governments are once again reviewing policies for the provision of maternity care. This paper presents findings from a state-wide Victorian survey of recent mothers conducted in 2000 regarding women?s experiences of antenatal care. We also offer some reflections on the way in which results from this and earlier Victorian surveys have been used, somewhat selectively, to support the State Government?s new framework for maternity services, while other issues highlighted in the survey results have been overlooked. Design: Population-based postal survey mailed to Victorian women who gave birth in a 2-week period in September 1999, 5?6 months after childbirth. Results: 42% of women attending a public hospital clinic described their antenatal care as ?very good? compared with 73% of women attending a birth centre, 59% attending private practitioners for antenatal care but receiving public intrapartum care (combined care), 56% attending a midwives clinic, 53% receiving shared care and 84% of women receiving private maternity care. The social characteristics of women enrolling in different models of care do not explain these differences. Immigrant women were much less likely to be happy with their care in pregnancy than Australian- born women, with no improvement in ratings of care over more than a decade.