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Obstetric Quality and Safety

Poster Session 2

(544) Association between Patient-Provider Communication and Patients’ Expectations versus Childbirth Experiences

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Foundation Awardee
Objective: Patient experience in relation to childbirth expectations is a crucial component of patient-centered care. Effective patient-provider communication may shape expectations and foster high-quality care. We aimed to test whether patient-provider communication is associated with concordance between patient expectations and birth experiences.

Study Design: English-speaking individuals, ≥18 years of age who were pregnant or delivered a live infant from May 2020 to July 2023 and received obstetric care at a large academic center were eligible to participate in a longitudinal online survey. Prenatally, participants indicated what they expected to experience during childbirth; they reported actual experiences in the postpartum survey. We used a scoring system (1–20) to assess alignment between expectations and experiences. Participants were categorized into “High” and “Low” alignment groups based on a median score. Patient-provider communication was measured using the Kim Alliance Scale–Communication Subscale (KAS-CM). We used a linear regression model for continuous alignment scores and negative binomial regression model for “High” alignment to calculate risk ratios (RR) and 95% confidence intervals.

Results: Of 407 participants who completed both surveys, the median alignment score was 15. Most participants were white (38%), college-educated (91%), had full-time employment (74%), and had private insurance (86%). An increase of 1 point on KAS-CM was associated with an increase in alignment score of 0.1 points (CI 0.002, 0.18). There was no statistically significant association between KAS-CM score and “High” alignment (RR 1.04, 95% CI 0.99, 1.09). Factors associated with “High” alignment included older age, prior cesarean section and multi-parity.

Conclusion: Quality patient-provider communication was modestly associated with a higher degree of concordance between patient expectations and birth experiences in this study population. However, future research should assess similar relationships among diverse, non-English speaking populations.