Skip to main content

Research Repository

Advanced Search

The comparison of the interpersonal action component of woman-centred care reported by healthy pregnant women in different sized practices in the Netherlands: A cross-sectional study

Kuipers, Yvonne (Fontein); van Beeck, Elise; van den Berg, Linda; Dijkhuizen, Mirjam


Elise van Beeck

Linda van den Berg

Mirjam Dijkhuizen


Background: The number of interventions is lower, and the level of satisfaction is higher among women who receive midwife-led primary care from one or two midwives, compared to more midwives. This suggests that midwives in small-sized practices practice more women-centred. This has yet to be explored.

Objective: To examine pregnant women’s perceptions, of the interpersonal action component of woman-centred care by primary care midwives, working in different sized practices.

Methods: A cross-sectional study using the Client Centred Care Questionnaire (CCCQ), administered during the third trimester of pregnancy among Dutch women receiving midwife-led primary care from midwives organised in small-sized practices (1-2 midwives), medium-sized (3-4 midwives) and large-sized practices (≥5 midwives). A Welch ANOVA with post hoc Bonferroni correction was performed to examine the differences.

Results: 553 completed questionnaires were received from 91 small-sized practices/104 women, 98 medium-sized practices/258 women and 65 large-sized practices/191 women. The overall sum scores varied between 57–72 on a minimum/maximum scoring range of 15-75. Women reported significantly higher woman-centred care scores of midwives in small-sized practices (score 70.7) compared with midwives in medium-sized practices (score 63.6) (p<.001) and large-sized practices (score 57.9) (p<.001), showing a large effect (d .88; d 1.56). Women reported statistically significant higher woman-centred care scores of midwives in medium-sized practices compared with large-sized practices (p<.001), showing a medium effect (d .69).

Conclusion: There is a significant variance in woman-centred care based on women’s perceptions of woman-midwife interactions in primary care midwifery, with highest scores reported by women
receiving care from a maximum of two midwives. Although the CCCQ scores of all practices are relatively high, the significant differences in favour of small-sized practices may contribute to moving woman centred care practice from ‘good’ to ‘excellent’ practice.

Journal Article Type Article
Acceptance Date Aug 17, 2020
Online Publication Date Sep 3, 2020
Publication Date 2021-07
Deposit Date Jan 10, 2022
Publicly Available Date Jan 11, 2022
Journal Women and Birth
Print ISSN 1871-5192
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 34
Issue 4
Pages e376-e383
Keywords Antenatal care, Client perceptions, Midwife-led care, Midwifery, Questionnaire, Woman-centred care
Public URL


You might also like

Downloadable Citations