Conceptual Frameworks for Understanding Postnatal Mothers’ Satisfaction with the Birthing Experience: A Narrative Review
DOI:
https://doi.org/10.14738/bjhr.1302.20201Abstract
Modern healthcare is increasingly emphasizing maternal satisfaction as the most important qualitative outcome of the childbirth experience. This narrative review aimed to categorize and evaluate the conceptual frameworks used to define and measure maternal satisfaction. A comprehensive search was conducted across electronic databases, including PubMed, EMBASE, and the Cochrane Library, supplemented by Google Scholar and Semantic Scholar. The AI tool Elicit was utilized to assist in screening scientific papers for thematic relevance. Search terms included satisfaction, conceptual frameworks, birthing experience, and postnatal mothers. This narrative review identifies a spectrum of frameworks varying in scope, focus, and theoretical origin. The Donabedian framework remains the foundational model for quality, while the WHO quality of care framework for maternal and neonatal health provides a holistic policy perspective by elevating respectful maternity care to a core dimension. The Hulton framework emphasizes institutional assessment. In contrast, the Hollins Martin and Dencker models are patient-driven, prioritizing internal, subjective experiences and patient-reported factors. The findings suggest a divide between the top-down quality assurance models (Donabedian, Hulton, WHO) and bottom-up, experience-based models (Hollins Martin, Dencker). No single framework provides a comprehensive multidimensional understanding of maternal satisfaction. This review suggests that researchers should consider integrating structural quality indicators with subjective patient-reported dimensions to fully capture the complexity of the birthing experience.
References
M. Silesh and T. Lemma, "Maternal satisfaction with intrapartum care and associated factors among postpartum women at public hospitals of North Shoa Zone Ethiopia," (in eng), PLoS One, vol. 16, no. 12, p. e0260710, 2021, doi: 10.1371/journal.pone.0260710.
F. Tolesa et al., "Maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals of the South West Shewa Zone, Ethiopia, 2022," (in eng), Front Glob Womens Health, vol. 4, p. 1203798, 2023, doi: 10.3389/fgwh.2023.1203798.
E. M. Elkhiary, S. Mohammed, and A. ElNemer, "Women’s Satisfaction with their Birthing Experience," Mansoura Nursing Journal, vol. 11, no. 1, pp. 119-132, 2024, doi: 10.21608/mnj.2024.350307.
H. Preis, B. L. Mahaffey, C. Heiselman, and M. Lobel, "The impacts of the COVID-19 pandemic on birth satisfaction in a prospective cohort of 2,341 U.S. women," Women and Birth, vol. 35, pp. 458 - 465, 2021.
A. Karlström, A. Nystedt, and I. Hildingsson, "The meaning of a very positive birth experience: focus groups discussions with women," BMC Pregnancy and Childbirth, vol. 15, 2015.
I. Olza et al., "Women's psychological experiences of physiological childbirth: a metasynthesis," (in eng), BMJ Open, vol. 8, no. 10, p. e020347, Oct 18 2018, doi: 10.1136/bmjopen-2017-020347.
WHO. WHO recommendations: Intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018. [Online]. Available: https://www.ncbi.nlm.nih.gov/books/NBK513802/table/executivesummary.tu1/
L. Takács, J. Seidlerová, L. Šulová, and S. H. Hoskovcová, "Social psychological predictors of satisfaction with intrapartum and postpartum care – what matters to women in Czech maternity hospitals?," Open Medicine, vol. 10, pp. 119 - 127, 2015.
A. Sawyer, S. Ayers, J. Abbott, G. Gyte, H. Rabe, and L. Duley, "Measures of satisfaction with care during labour and birth: a comparative review," BMC Pregnancy and Childbirth, vol. 13, pp. 108 - 108, 2013.
P. Carquillat, F. Vendittelli, T. V. Perneger, and M.-J. Guittier, "Development of a questionnaire for assessing the childbirth experience (QACE)," BMC Pregnancy and Childbirth,
A. Srivastava, B. I. Avan, P. R. Rajbangshi, and S. Bhattacharyya, "Determinants of women’s satisfaction with maternal health care: a review of literature from developing countries," BMC Pregnancy and Childbirth, vol. 15, 2015.
A. Donabedian, "Evaluating the quality of medical care. 1966," (in eng), Milbank Q, vol. 83, no. 4, pp. 691-729, 2005, doi: 10.1111/j.1468-0009.2005.00397.x.
H. Vyas, M. O. J, and P. Bhardwaj, "Maternal satisfaction among mothers delivering at public health facilities in India: a narrative review," International Journal Of Community Medicine Scholar Publishing And Public Health, vol. 9, no. 7, pp. 3030-3033, 06/28 2022, doi: 10.18203/2394-6040.ijcmph20221579.
T. Takayama et al., "Is the place of birth related to the mother’s satisfaction with childbirth? A cross-sectional study in a rural district of the Lao People’s Democratic Republic (Lao PDR)," BMC Pregnancy and Childbirth, vol. 19, no. 1, p. 333, 2019/09/11 2019, doi: 10.1186/s12884-019-2483-4.
L. A. Hulton, Z. Matthews, and R. W. Stones, "Applying a framework for assessing the quality of maternal health services in urban India," (in eng), Soc Sci Med, vol. 64, no. 10, pp. 2083-95, May 2007, doi: 10.1016/j.socscimed.2007.01.019.
M. A. Bohren, "WHO Recommendations: Intrapartum care for a positive childbirth experience," 2018.
C. J. Hollins Martin and C. R. Martin, "Development and psychometric properties of the Birth Satisfaction Scale-Revised (BSS-R)," Midwifery, vol. 30, no. 6, pp. 610-619, 2014/06/01/2014, doi: https://doi.org/10.1016/j.midw.2013.10.006.
C. R. Martin, C. Hollins Martin, and M. Redshaw, "The Birth Satisfaction Scale-Revised Indicator (BSS-RI)," BMC Pregnancy and Childbirth, vol. 17, no. 1, p. 277, 2017/08/29 2017, doi: 10.1186/s12884-017-1459-5.
J. L. D'Sa, I. O. Jahlan, E. S. Alsatari, S. Zamzam, and C. R. Martin, "Psychometric properties of a Saudi Arabian version of the Birth Satisfaction Scale-Revised (BSS-R)," (in eng), Belitung Nurs J, vol. 10, no. 1, pp. 105-113, 2024, doi: 10.33546/bnj.3055.
A. Dencker, C. Taft, L. Bergqvist, H. Lilja, and M. Berg, "Childbirth experience questionnaire (CEQ): development and evaluation of a multidimensional instrument," (in eng), BMC Pregnancy Childbirth, vol. 10, p. 81, Dec 10 2010, doi: 10.1186/1471-2393-10-81.
S. Batram-Zantvoort, L. Wandschneider, O. Razum, and C. Miani, "A critical review: developing a birth integrity framework for epidemiological studies through metaethnography," BMC Women's Health, vol. 23, no. 1, p. 530, 2023/10/10 2023, doi: 10.1186/s12905-023-02670-z.
D. Maxwell, S. R. Leat, T. Gallegos, and R. T. Praetorius, "Sacred space: a qualitative interpretive meta-synthesis of women’s experiences of supportive birthing environments," BMC Pregnancy and Childbirth, vol. 24, 2024.
O. a. N. N. Association of Women’s Health, "Respectful Maternity Care Framework and Evidence-Based Clinical Practice Guideline," (in eng), J Obstet Gynecol Neonatal Nurs, vol. 51, no. 2, pp. e3-e54, Mar 2022, doi: 10.1016/j.jogn.2022.01.001.
L. N. Namusonge, "Modified Conceptual Framework for Respectful Maternity Care for Promoting Quality in Health Facilities," East African Journal of Health and Science, 2025.
K. I. Mohammad, I. A. Shaban, C. S. E. Homer, and D. K. Creedy, "Women's satisfaction with hospital-based intrapartum care: A Jordanian study," International Journal of Nursing, vol. 6, pp. 32-39, 2014.
N. Pakari, S. T. Zahrani, M. Nasiri, and Z. Mahmoodi, "Persian Translation and Psychometric Testing of the Scales for Measuring Maternal Satisfaction in Normal and Caesarean Birth," Biosciences, Biotechnology Research Asia, vol. 13, pp. 339-346, 2016.
F. Imtithal Adnan, N. M. Noor, and N. A. Mat Junoh, "Associated factors of labor satisfaction and predictor of postnatal satisfaction in the north-east of Peninsular Malaysia," PLoS ONE, Scholar Publishing
Ma, B. C. Ferrer, M. C. Jordana, C. B. Meseguer, C. C. García, and E. M. Roche, "Comparative study analysing women's childbirth satisfaction and obstetric outcomes across two different models of maternity care," BMJ Open, vol. 6, 2016.
R. Navas Arrebola, L. Peteiro Mahía, S. Blanco López, N. López Castiñeira, T. Seoane Pillado, and S. Pertega Díaz, "Women's satisfaction with childbirth and postpartum care and associated variables," (in eng spa), Rev Esc Enferm USP, vol. 55, p. e03720, 2021, doi: 10.1590/s1980-220x2020006603720.
F. H. Weeks, L. Pantoja, J. Ortiz, J. W. Foster, G. Cavada, and L. Binfa, "Labor and Birth Care Satisfaction Associated With Medical Interventions and Accompaniment During Labor Among Chilean Women," Journal of Midwifery and Women'S Health, vol. 62, pp. 196–203, 2017.
M. Iravani, E. Zarean, M. Janghorbani, and M. Bahrami, "Women's needs and expectations during normal labor and delivery," (in eng), J Educ Health Promot, vol. 4, p. 6, 2015, doi: 10.4103/2277-9531.151885.
F. Alderdice, J. Henderson, C. Opondo, M. Lobel, M. A. Quigley, and M. Redshaw, "Psychosocial factors that mediate the association between mode of birth and maternal postnatal adjustment: findings from a population-based survey," BMC Women's Health, vol. 19, 2019.
K. Y. Çalık, Ö. Karabulutlu, and C. Yavuz, "First do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study," BMC Pregnancy and Childbirth,
L. H. Brubaker, I. M. Paul, J. T. Repke, and K. H. Kjerulff, "Early maternal-newborn contact and positive birth experience," Birth, vol. 46, pp. 42–50, 2018.
R. Webb et al., "When birth is not as expected: a systematic review of the impact of a mismatch between expectations and experiences," BMC Pregnancy and Childbirth, vol. 21, 2021.
P. Catalá, C. Peñacoba, J. Carmona, and D. Marín, "Do maternal personality variables influence childbirth satisfaction? A longitudinal study in low-risk pregnancies," Women & Health, vol. 60, pp. 197 - 211, 2020.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Mutinke Zulu, Bellington Vwalika, Kaorolin Maeland, Concepta Kwaleyela
This work is licensed under a Creative Commons Attribution 4.0 International License.
