How do women fare during and after pregnancy in different areas? And how do they actually experience care? Collaboration around the pregnant woman was already being used in birth care, but there was still little insight into care outcomes from the patient perspective. In her PhD thesis, doctor and researcher Alies Depla investigated how structured questionnaires on patient-reported outcomes could contribute to better care. She will receive her PhD at UMC Utrecht on 11 May on the topic of outcome-based birth care.

Alies Depla's research connected several pilots in Obstetric Collaborative Groups, which include, for example, hospitals, maternity care and obstetric practices. She started working with different questionnaires, the so-called PROMs and PREMs.  PROMs are questionnaires that ask how the woman feels and how she is doing. These include questions on, for instance, pain, fatigue and emotional state. PREMs are questionnaires that provide insight into the woman's experience and satisfaction with the care provided.  

Pregnant women and women (just) giving birth filled in questionnaires on perceived health and experiences at different times. Alies: "The questions made the women more aware of how they felt. This made it clearer to the healthcare providers earlier what was on their minds, as the women discussed the answers with the midwife or gynaecologist in the consultation room. This brought earlier attention to symptoms and also the psychosocial aspects of care that matter to the woman."

Focus on pregnant woman

"My focus was on strengthening the regional network of all healthcare providers involved, putting the pregnant woman at the centre. In this, there is a lot to gain in how she experiences care." In regional sessions with all kinds of members of Obstetric Partnerships, we organised conversations between, for example, gynaecologists, midwives and maternity nurses. During those sessions, we created a shared picture of the patient population and key themes based on data. We translated these themes into a recognisable case. In groups, we discussed the case and came up with improvement suggestions for practice. To improve care, engaging in such an interdisciplinary conversation is the most important thing. Healthcare professionals learn from each other's perspective and experiences. By working well together, they can improve patient care.'

Working together in birth care

"This study shows that structural investment in data infrastructure and network collaboration are needed to achieve implementation of PROM and PREM in birth care. Discussing individual results can contribute to personalised care for pregnant women and women who have just given birth, if properly tailored to a woman's care pathway," says Alies. "Putting women at the centre of care and quality improvement requires cross-organisational cooperation in (birth) care. For this, it helps if gynaecologists, midwives and maternity nurses meet regularly, have interdisciplinary discussions and learn from each other." 

The thesis can be found as a pdf at https://www.publicatie-online.nl/publicaties/alies-depla (unlock-code 162889).