South Australian rural women's views of their pregnancy, birthing and postnatal care

Introduction: This study considered the views and experiences of 85 rural women, most of whom gave birth in two regional South Australian hospitals. Method: This descriptive survey used a validated questionnaire, modified for use in rural South Australia, which included open-ended questions to invite further comment. Women were invited to participate while in hospital after giving birth and those who agreed (n = 136) were mailed a questionnaire 6-8 weeks after the birth. Data were collected on demographic and other information including: age, smoking status, model of antenatal and birth care, birth method, women's views of their care in pregnancy, labour and after the birth, breastfeeding uptake and continuance rates, and prevalence of possible depression after birth using the Edinburgh Postnatal Depression Scale. Non-identifiable data were described using descriptive statistics and analysed using t-tests, 2 x 2 contingency tables and relative risks, as appropriate. Where available, comparisons were made with other rural and South Australian data. Qualitative data were themed by consensus. Results: Eighty-five women (63%) returned a completed questionnaire. Rates of spontaneous vaginal birth were significantly lower in the study than for 5257 South Australian rural residents who gave birth in 2006 (n = 38, 45% vs 3057, 58%). While caesarean rates overall were similar, elective caesarean rates were higher (25% vs 15%), while fewer study women smoked throughout pregnancy (9% vs 24%). Overall, women in the study rated their care as 'very good' for antenatal care(59%), for labour and birth care (73%) and postnatal care (53%). More women stayed in hospital for 5 days or more than South Australian women overall (53% vs 40%). Open-ended comments confirmed reasons that were related to their choice. Breastfeeding was commenced by 95% of the women and 69% were breastfeeding at 6 weeks. Conclusions: The findings confirm Victorian rural women's ratings, and further highlight that in the postnatal period women often feel left to manage on their own, and are less than happy with their care.