What women identify as positive aspects and areas for improvement of maternity care and services in Ireland: An online survey

Published:November 26, 2022DOI:



      An important aspect of achieving the provision of woman-centred maternity services is to seek women’s experiences of maternity care.


      To explore women’s experiences of the care received within the Irish maternity system and to identify aspects of positive care and areas requiring improvement.


      The Babies Born Better pan-European online survey asked open-ended questions on positive aspects of care and aspects of care that could be improved. Data from women who birthed in Ireland within the previous five years were included. Socio-demographic data were analysed descriptively, and descriptive content analysis was conducted for the qualitative comments.


      Data from 736 participants were included. Four categories were generated from the analysis: Women’s interactions with healthcare professionals included five sub-categories of competence and expertise, continuity and consistency, respectful care, communication, and shared decision-making; Interventions and procedures included the five sub-categories of medical interventions, breastfeeding support, pain relief, birth partner’s presence and involvement, and facilitating mother and baby attachment; Organisational and infrastructural issues contained three sub-categories of facilities and services, environment and atmosphere, and staffing levels; and the fourth category, Overall evaluations and specific statements, showed the diversity of women’s experiences within the services.


      Several positive aspects of care within the Irish maternity services were identified, many of which related to interpersonal factors and interactions with healthcare professionals. The findings also revealed what could be changed, some of which would require minimal resources or effort, so that women would experience positive care.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Women and Birth
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Downe S.
        • Finlayson K.
        • Oladapo O.T.
        • Bonet M.
        • Gülmezoglu A.M.
        What matters to women during childbirth: a systematic qualitative review.
        PLoS One. 2018; 13e0194906
        • Bell A.F.
        • Andersson E.
        The birth experience and women's postnatal depression: a systematic review.
        Midwifery. 2016; 39: 112-123
        • Bell A.
        • Carter C.
        • Davis J.
        • et al.
        Childbirth and symptoms of postpartum depression and anxiety: a prospective birth cohort study.
        Arch. Women’s. Ment. Health. 2016; 19: 219-227
        • Gottvall K.
        • Waldenström U.
        Does a traumatic birth experience have an impact on future reproduction?.
        BJOG. 2002; 109: 254-260
        • Tunçalp Ӧ
        • Were W.
        • MacLennan C.
        • et al.
        Quality of care for pregnant women and newborns—the WHO vision.
        BJOG. 2015; 122: 1045-1049
        • Devane D.
        • Murphy-Lawless J.
        • Begley C.M.
        Childbirth policies and practices in Ireland and the journey towards midwifery-led care.
        Midwifery. 2007; 23: 92-101
        • Hunter A.
        • Devane D.
        • Houghton C.
        • Grealish A.
        • Tully A.
        • Smith V.
        Woman-centred care during pregnancy and birth in Ireland: thematic analysis of women’s and clinicians’ experiences.
        BMC Pregnancy Childbirth. 2017; 17: 322
      1. Healthcare Pricing Office, Health Service Executive. Perinatal Statistics Report, 2017. Dublin, 2020.

      2. National Women and Infants Health Programme. Irish Maternity Indicator System National Report 2020. Ireland: National Women and Infants Health Programme, 2021. 〈〉.

      3. Central Statistics Office. Vital Statistics Annual Report 2017: Births 2017. Dublin, 2019. 〈∼:text=The%20highest%20number%20of%20births%20in%202017%20was%20recorded%20in,13.2%25%20of%20all%20births%20respectively〉.

      4. Meaney S.B.A., Corcoran P., Greene RA on behalf of the Designated Midwifery Officers. Planned Home Births in Ireland Annual Report 2017; HSE National Home Birth Service provided by Self Employed Community Midwives. Cork, 2020.

        • Department of Health
        Creating a Better Future Together: National Maternity Strategy 2016-2026.
        Department of Health, Dublin2016
      5. Babies Born Better; Improving Childbirth Experiences. 2020. 〈〉 (accessed 1 May 2022).

        • Vaismoradi M.
        • Turunen H.
        • Bondas T.
        Content analysis and thematic analysis: implications for conducting a qualitative descriptive study.
        Nurs. amp; Health Sci. 2013; 15: 398-405
        • Zora Raboteg-Šarić A.
        • Brajša-Žganec
        • Mujkić A.
        Optimising childbirth in croatia – mothers’ perceptions of the best experience and their suggestions for change.
        Cent. Eur. J. Paed. 2017; 13: 117-129
        • Gouni O.
        Mothers’ perceptions of their birth experience in greece: could we do any better than that? Research analysis of the babies born better survey for Greece.
        Int J. Prenat. Life Sci. 2020; : 1-60
        • Benet M.
        • Escuriet R.
        • Palomar-Ruiz L.
        • Ruiz-Berdún D.
        • Leon-Larios F.
        Women's agenda for the improvement of childbirth care: evaluation of the babies born better survey data set in Spain.
        Birth. 2020; 47: 365-377
        • Vedeler C.
        • Nilsen A.
        • Blix E.
        • Downe S.
        • Eri T.
        What women emphasise as important aspects of care in childbirth – an online survey.
        BJOG. 2021;
        • Skoko E.
        • Ravaldi C.
        • Vannacci A.
        • et al.
        Findings from the Italian babies born better survey.
        Minerva Ginecol. 2018; 70: 663-675
      6. Heidi P., Marci L., Yael B. Between Expectancy and Experience: Testing a Model of Childbirth Satisfaction. Psychology of women quarterly 2019.

      7. The National Maternity Experience Survey. National Maternity Experience Survey: Findings of the National Maternity Experience Survey 2020. Dublin, 2020.〈〉.

        • Vedam S.
        • Stoll K.
        • Taiwo T.K.
        • et al.
        The giving voice to mothers study: inequity and mistreatment during pregnancy and childbirth in the United States.
        Reprod. Health. 2019; 16: 1
        • Bohren M.A.
        • Tunçalp Ö.
        • Miller S.
        Transforming intrapartum care: respectful maternity care.
        Best. Pract. Res. Clin. Obstet. Gynaecol. 2020; 67: 113-126
        • Dado M.
        • Smith V.
        • Barry P.
        Women's experiences of water immersion during labour and childbirth in a hospital setting in Ireland: a qualitative study.
        Midwifery. 2022; 103278
      8. Health Information and Quality Authority. Overview report of HIQA’s monitoring programme against the National Standards for Safer Better Maternity Services, with a focus on obstetric emergencies. Dublin, Ireland., 2020. 〈–02/Maternity-Overview-Report.pdf〉.

        • Department of Health
        National Maternity Strategy: Revised Implementation Plan 2021-2026.
        Department of Health, Dublin2021
      9. National Women and Infants Health Programme. Irish Maternity Indicator System National Report 2019. Dublin, 2020. 〈〉.

      10. Health Service Executive National Breastfeeding Implementation Group. The Mapping Project 2017: Report of the review of breastfeeding resources in Maternity Hospitals/Units and Community Health Organisations. Dublin, 2017. 〈〉.

        • Department of Health
        Minister Donnelly Prioritises Supports for Mothers to Breastfeed.
        Department of Health, Dublin2021
        • Fatemeh Zahra K.
        • Hamid Heidarian M.
        • Talat K.
        • Nahid M.-S.
        The effect of mother-infant skin-to-skin contact immediately after birth on exclusive breastfeeding: a systematic review and meta-analysis.
        J. Turk. -Ger. Gynecol. Assoc. 2020; 21: 46-56
        • Brubaker L.H.
        • Paul I.M.
        • Repke J.T.
        • Kjerulff K.H.
        Early maternal-newborn contact and positive birth experience.
        Birth. 2019; 46: 42-50
        • Kalimeri K.
        • Mariano
        • Andrea Cattuto C.
        Evaluation of biases in self-reported demographic and psychometric information: traditional versus Facebook-based surveys.
        arXiv pre-Print. Serv. 2019;