[Description and prevention of maternity claims]

Abstract

Objectives: Quantify and describe the reasons for complaints in maternity, then identify patients at risk of complaining.

Methods: Retrospective observational study of complaints relating to medical or nursing care, then case-control study (one case, two consecutive unmatched controls). Demographic, maternal, obstetric and postpartum characteristics were compared using univariate and then multivariate analysis.

Results: Between 2018 and 2022, 26,049 patients gave birth at the Port-Royal maternity ward. Among them, 50 (2‰) complained to the patients' rights department and were compared to 100 controls. The three main reasons for complaints were a lack of information (58%), an incorrect attitude of professionals (44%) and medical care considered unsuitable (30%). In univariate analysis, the risk factors for complaints were psychological or psychiatric background (20 vs. 7%, P=0.02), twinning (16 vs. 3%, P=0.01), the occurrence of a fetal pathology (20% 6%, P=0.01), duration of labor≥12hours (30 vs. 16%, P=0.04), and hospitalization of the child in neonatology (18 vs. 5%, P=0.01). In multivariate analysis, twinning (OR 95% CI 4.74 [0.97-23.23]) and duration of work≥12hours (OR 95% CI 2.45 [0.96-6.27]) were associated with a non-significant increase in complaints.

Conclusion: These results reveal areas for improvement in the care of maternity patients in general, and in certain at-risk patients more specifically.

Keywords: Accouchement; Childbirth; Complaints; Droits des patients; Grossesse; Information; Patient rights; Pregnancy; Réclamations.