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PhD Defence Cherelle van Stenus

through their eyes - experiences of clients and professionals with obstetric and neonatal healthcare during pregnancy, childbirth, and post-partum period

Cherelle van Stenus is a PhD student in the Department of Public Administration (PA). Her supervisor is prof.dr. A. Need from the Faculty of Behavioural, Management and Social sciences (BMS).

Client experiences are an important aspect of obstetric and neonatal healthcare. In the Netherlands, various healthcare professionals guide pregnant women and new mothers. Different healthcare professionals providing guidance and treatment can lead to discontinuity of care. This can negatively influence client satisfaction and therefore quality of care. This thesis, and literature, suggests that women transferred during childbirth are less satisfied with the care provision and the quality of care than those not transferred. Dissatisfaction with the care provided during pregnancy, childbirth and the postpartum period can have serious adverse effects on the physical, mental, and physiological state of the client. As an indicator of the quality of the care, client experiences and satisfaction are becoming more important. Client experiences and satisfaction provide in-depth information about how the obstetric and neonatal healthcare system performs, which in turn can be used to improve

the quality of care. Therefore, Dutch obstetric and neonatal healthcare professionals work towards maintaining and improving client experiences and satisfaction. The value of this study’s mixed methods approach is that the results of the different sub-studies complement one another and endeavor to provide an in-depth examination of the research aim. The aim of this thesis is to investigate clients’ and professionals’ experiences with Dutch obstetric and neonatal healthcare by highlighting their experiences with transfers of care.

The experiences of clients with Dutch obstetric and neonatal healthcare, included in several chapters in this thesis, showed that, in general, Dutch mothers are very satisfied with the provided healthcare during their pregnancy, childbirth and postpartum period. We gained a better understanding about how transfers of care can influence the satisfaction with obstetric and neonatal healthcare in women with uncomplicated pregnancies. Namely, women who experienced a transfer during childbirth were less satisfied with the provided healthcare than women who did not experiences a transfer of care. Just like the clients, professionals were in general satisfied with how they transferred their clients and how colleagues transferred their clients to them. Continuity of care benefits from a situation where professionals know each other in person and trust each other’s capabilities. Logically, obstetric and neonatal healthcare professionals want their clients to look back on their healthcare

experiences as positively as possible. This is of course idealistic, but taking into account the long-term effects associated with negative experiences, this is definitely something to work towards.