Abstract
Background Low-educated native Dutch and non-western minority women have inadequate access to obstetric care. Moreover, the care they receive lacks responsiveness to their needs and cultural competences. Gaining a deeper understanding of their experiences and satisfaction with antenatal, birthing and maternity care will help to adjust healthcare responsiveness to meet their needs during pregnancy, childbirth and the postpartum period. Methods We combined the World Health Organization conceptual framework of healthcare responsiveness with focus group research to measure satisfaction with antenatal, birthing and maternity care of women with a low-educated native Dutch and non-western ethnic background. Results From September 2011 until December 2013, 106 women were recruited for 20 focus group sessions. Eighty-five percent of the women had a non-western immigrant background and 89% a low or intermediate educational attainment. The study population was mostly positive about the provided care during the antenatal phase. They were less positive about the other two phases of care. Moreover, the obstetric healthcare systems’ responsiveness in all phases of care (antenatal, birthing and maternity) did not meet these women’s needs. The ‘respect for persons’ domains ‘autonomy’, ‘communication’ and ‘dignity’ and the ‘client orientation’ domain ‘prompt attention’ were judged most negatively. PLOS ONE | January 31, 2019 1 / 22 OPEN ACCESS Citation: Peters IA, Posthumus AG, Steegers EAP, Denktaş S (2019) Satisfaction with obstetric care in a population of low-educated native Dutch and non-western minority women. Focus group research. PLoS ONE 14(1): e0210506. https://doi. org/10.1371/journal.pone.0210506 Editor: Sherif A. Shazly, Mayo Clinic Minnesota, UNITED STATES Received: September 10, 2018 Accepted: December 24, 2018 Published: January 31, 2019 Copyright: © 2019 Peters et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All not identifying focus group transcript files are available from the ‘DANS KNAW database’ (https://dans.knaw.nl): The information provided by DANS is not sufficient to replicate the study findings, but it supports to comprehend the study outcomes. More identifying information is available upon request by qualified researchers by contacting the Committee Scientific Integrity and Quality of the Erasmus Medical Centre: cwivg@erasmusmc.nl. This committee will examine, after consultation of the Medical Ethical Conclusions The study findings give contextual meaning and starting points for improvement of responsiveness in the provision of obstetric care within a multi-ethnic wo