Cultural differences in postnatal quality of life among German-speaking women’ at the OPTIMISE2014 Conference Optimising Childbirth across Europe: An interdisciplinary maternity care conference, Brussels, Belgium, April 2014

Abstract

INTRODUCTION: Assessment of quality of life after childbirth constitutes an important health-outcome measurement for childbearing women and midwifery. The Mother-Generated Index (MGI) is a validated instrument used to assess postnatal quality of life. The tool has not been applied for cross-cultural comparison before. STUDY AIMS: to investigate (a) responses to the MGI in German-speaking women; and (b) associations between MGI scores, maternity and midwifery care. ETHICAL APPROVAL: received from the university. METHODLOGY: A two-stage survey including a follow-up was conducted in two rural hospitals in the south of Germany and in the north of Switzerland. Both questionnaires included the MGI, socio-demographic, health and maternity-care-related questions and were distributed during the first days and six weeks postpartum. The surveys were developed during a STSM. Parametric and nonparametric tests were computed with SPSS. FINDINGS: A total of 129 questionnaires were returned three days and 83 seven weeks after birth. There were no significant differences in the MGI scores between German and Swiss women at both times p=0.22, p=0.43). At three weeks significantly higher MGI scores were associated with (a) more information (p=0.01) and better support (p=0.02) in hospital, and at seven weeks (c) more adequate information during pregnancy ( p=0.02); (d) higher rated birth experience ( p<0.01), (e) having had an epidural anaesthesia ( p<0.01); (f) , higher self-esteem of coping ( p<0.01); (g), more support at home ( p=0.03); and (h) less disturbed sleep ( p<0.01). Significantly lower MGI scores were associated with a private doctor attending birth (p=0.01) and exclusively breastfeeding (p=0.04). CONCLUSION: The tool is able to detect differences in postnatal quality of life among women with more divergent cultural backgrounds. Gaps in maternity and midwifery care were detected. The MGI has potential as a toll in cross-cultural comparative maternit