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Measures of satisfaction with care during labour and birth: a comparative review

Alexandra Sawyer1, Susan Ayers2*, Jane Abbott3, Gillian Gyte4, Heike Rabe5 and Lelia Duley6

Author Affiliations

1 School of Psychology, University of Sussex, Brighton, East Sussex, UK

2 School of Health Sciences, City University London, 20 Bartholomew Close, London, UK

3 Jane Abbott, Bliss (The Special Care Baby Charity), 9 Holyrood Street, London, UK

4 Gillian Gyte, National Childbirth Trust, Alexandra House, Oldham Terrace, London, UK

5 Heike Rabe, Academic Department of Paediatrics, Brighton and Sussex University Hospitals Trust, Royal Alexandra Children’s Hospital, Eastern Road, Brighton, UK

6 Lelia Duley, Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK

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BMC Pregnancy and Childbirth 2013, 13:108  doi:10.1186/1471-2393-13-108

Published: 8 May 2013



Satisfaction is the one of the most frequently reported outcome measures for quality of care. Assessment of satisfaction with maternity services is crucial, and psychometrically sound measures are needed if this is to inform health practices. This paper comparatively reviews current measures of satisfaction with care during labour and birth.


A review of the literature was conducted. Studies were located through computerised databases and hand searching references of identified articles and reviews. Inclusion criteria were that the questionnaire was a multi-item scale of satisfaction with care during labour and birth, and some form of psychometric information (either information about questionnaire construction, or reliability, or validity) had to be reported.


Nine questionnaires of satisfaction with care during labour and birth were identified. Instruments varied in psychometric properties and dimensions. Most described questionnaire construction and tested some form of reliability and validity. Measures were generally not based on the main theoretical models of satisfaction and varied in scope and application to different types of samples (e.g. satisfaction following caesarean section). For an in-depth measure of satisfaction with intrapartum care, the Intrapartal-Specific Quality from the Patient’s Perspective questionnaire (QPP-I) is recommended. Brief measures with good reliability and validity are provided by the Six Simple Questions (SSQ) or Perceptions of Care Adjective Checklist (PCACL-R).


Despite the interest in measures of satisfaction there are only a small number of validated measures of satisfaction with care during labour and birth. It is important that brief, reliable and valid measures are available for use in general and specific populations in order to assist research and inform practice.

Patient satisfaction; Labour; Birth; Questionnaire; Measurement