Women’s Satisfaction and Perceived Quality of Emergency Obstetric Care:  Mixed-Methods Multi-centre Study

When a woman faces a life-threatening complication during childbirth, the immediate goal is survival. Doctors and nurses work to stop bleeding, lower dangerously high blood pressure, or deliver a baby when labor stalls. But for the woman in the bed, the experience involves much more than just the medical procedure. It involves how she is spoken to, whether she feels respected, if she understands what is happening, and if she receives emotional support while her body recovers. In the field of maternal health, these human elements are now recognized as just as critical as the surgery itself. If a woman feels ignored, shouted at, or treated without dignity, she may lose trust in the medical system, making her less likely to seek help in the future. This creates a difficult gap: a hospital might save a life perfectly well, yet the woman leaves feeling humiliated or scared. Understanding this gap requires listening not only to the medical outcomes but to the stories of the women who lived through the emergency and the staff who treated them.

In a recent study conducted in Benin City, Nigeria, researchers set out to measure this experience directly. They focused on two major hospitals, the University of Benin Teaching Hospital and the Edo Specialist Hospital, where women had recently given birth after facing an obstetric emergency. The team wanted to know if these women felt satisfied with the care they received and if they felt treated with dignity. To get a complete picture, they did not rely on just one method. They asked 228 women to fill out detailed surveys about their care, covering specific areas like respect, communication, and emotional support. At the same time, they held group discussions with women who had been treated and interviewed doctors and midwives who worked in the emergency units. This approach allowed them to compare the numbers from the surveys with the personal stories shared in the interviews.

The results painted a complex picture. Overall, the vast majority of women, about 92 percent, reported being highly satisfied with their care. They felt they were treated with dignity and respect, that the staff communicated well, and that they received supportive care. This high level of satisfaction suggests that, in many cases, the medical teams are succeeding in providing not just life-saving treatment but also humane care. However, the study also found that this positive feeling was not universal. Women who underwent an operative delivery, such as a cesarean section, were significantly more likely to report poor satisfaction compared to those who had a non-operative birth. The data showed that women who had surgery were more than four times as likely to feel dissatisfied. This finding points to a specific area where the system is struggling: the experience of women who require surgical intervention often falls short, even when the surgery itself is successful.

When the researchers looked deeper into the stories behind the numbers, they found that the high satisfaction scores were masking several serious problems. While women praised the speed and skill of the medical teams, many also described harsh interactions, such as being shouted at or ignored. They spoke about the stress of not understanding the medical language used by staff, which made it hard to give informed consent or feel in control of their situation. The interviews with the healthcare workers revealed why these gaps exist. Doctors and nurses described being overwhelmed by heavy workloads, with too few staff members to handle the number of emergencies. They mentioned shortages of essential equipment, delays in getting blood for transfusions, and overcrowded wards. One doctor noted the pressure of having only one staff member on duty while facing four simultaneous emergencies. These systemic issues, invisible in a simple satisfaction score, directly impact the quality of the human interaction.

Financial barriers also emerged as a major obstacle. Both the women and the staff reported that the need to pay for tests, surgery, or even basic supplies before receiving treatment could delay critical care. In some cases, families had to scramble to find money or materials while the woman was in distress. However, the study also highlighted a positive factor: programs that help cover these costs were highly valued. Women who received financial support through specific health programs felt much more secure and rated their care experience much higher. This suggests that removing the fear of cost is a powerful way to improve the overall experience of emergency care.

The study concludes that while the medical teams in these Nigerian hospitals are doing a remarkable job saving lives and earning high marks for respect, there is still work to be done. The high satisfaction rates do not mean the system is perfect; rather, they show that the core mission of saving lives is being met, but the human side of that mission needs strengthening. The researchers found that the most significant challenges lie in supporting women who undergo surgery, improving communication between staff and patients, and addressing the shortages of staff and equipment that strain the system. By focusing on these specific areas—better post-surgery support, clearer communication, and more reliable resources—the hospitals can ensure that the care they provide is not only effective but also truly respectful and supportive for every woman who walks through their doors.