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Blackwell Publishing LtdOxford, UKJEPJournal of Evaluation in Clinical Practice1356 1294© 2007 The Authors; Journal compilation © 2007 Blackwell Publishing Ltd? 2007143391398Original Article The careJ. Jomeen and C.R. Martin

impact of choice of maternity

Journal of Evaluation in Clinical Practice ISSN 1356-1294

The impact of choice of maternity care on psychological health outcomes for women during pregnancy and the postnatal period
Julie Jomeen PhD MA RM RGN1 and Colin R. Martin C. Psychol. PhD2
1 2

Midwifery Lecturer, Faculty of Health and Social Care, University of Hull, Hull, UK Reader, Psychology Group, School of Health and Human Sciences, Leeds Metropolitan University, Leeds, UK

Keywords childbirth, choice, maternity care, pregnancy, psychological outcomes Correspondence Dr Julie Jomeen Faculty of Health and Social Care 234 Dearne Building University of Hull Cottingham Road Hull HU6 7RX UK E-mail: [e-mail] Accepted for publication: 11 January 2007 doi:10.1111/j.1365-2753.2007.00878.x

Abstract
Rationale Psychological factors are acknowledged to impact on pregnancy, birth, neonatal outcomes and maternal mental health. The importance of psychological well-being is now recognized within maternity care and UK maternity policy advocates choice and control, equating this to increased quality of experience and improved psychological outcomes. There remains, however, lack of substantive and consistent evidence with regard to the psychological benefits of choice in maternity care. The aim of this study is to investigate the impact of choice of maternity care on psychological health outcomes. Methods 165 antenatal women were recruited and sampled according to their choices for care. Women were assessed utilizing the Hospital Anxiety and Depression Scale (HADS), Edinburgh Postnatal Depression Scale (EPDS), Cambridge Worry Scale (CWS), Multidimensional Health Locus of Control (MHLC), SF-36, Pittsburgh Sleep Quality Index (PSQI) and Culture