Experience of postpartum women with the care received under the comprehensive birth model: A mixed‐methods study in a high‐complexity public hospital in Chile
Maria Antonieta Silva‐Muñoz, Cristian Carreño‐León, Claudia Vilches‐Arredondo, Jenny Zárate‐Mesa, Jonathan Gálvez‐Arancibia, Alejandra Figueroa‐CañeteAbstract
Objective
The comprehensive birth model (CBM) seeks to promote humanized care, maternal autonomy, and emotional bonding. However, its application in high‐complexity hospitals presents inconsistencies depending on the mode of delivery. The aim of the present study was to evaluate postpartum women's experience with the CBM and identify quality perception differences based on the mode of delivery in a Chilean high‐complexity public hospital.
Methods
A concurrent exploratory mixed‐methods study (QUAN + QUAL) was conducted at a high‐complexity reference hospital in Viña del Mar, Chile. The quantitative phase included 345 postpartum women (184 vaginal births, 158 cesarean sections and 3 forceps) who completed the BMSP2 scale; data were analyzed using Mann–Whitney U test, rank‐biserial correlation () for effect size, and robust linear regression (Huber's M‐estimator). The qualitative phase involved a different cohort of 26 postpartum women participating in in‐depth interviews analyzed via thematic analysis, validated with Cohen's kappa ( κ = 0.86; 95% confidence interval [CI]: 0.78–0.92). Integration followed GRAMMS guidelines.
Results
Women reported high overall satisfaction, particularly in relational care. However, cesarean sections yielded significantly lower scores in self‐care and comfort (), and mother–child contact (). Interviews suggested perceived discontinuities in autonomy, comfort, and early bonding within surgical care contexts.
Conclusion
CBM implementation demonstrates positive relational care experiences but also suggests the presence of structural and operational challenges within cesarean care processes. Midwifery leaders and managers should prioritize the standardization of humanization strategies in surgical settings to support early post‐cesarean bonding and promote continuity of relational care throughout the postpartum period.