Exploring the Factors Influencing Maternity Care Experiences Among Postpartum Women in Ondo State, Nigeria
Keywords:
Maternity care experiences, Expectation disconfirmation, Respectful maternity care, Mixed-methods study, Postpartum womenAbstract
Maternity care experiences significantly influence women' s trust in health systems, future care- seeking behaviour, and maternal- neonatal health outcomes. In Nigeria, where the maternal mortality ratio remains high at approximately 993 per 100, 100,000 live births (2023 modelled estimate) and skilled birth attendance is only 43%, poor experiences and expectation disconfirmation are contributing factors to low utilisation of facility- based services. This study investigated socio-demographic, interpersonal, and structural factors influencing maternity care experiences among postpartum women in Ondo State, Nigeria. A concurrent mixed- methods design was employed. Purposive sampling recruited 422 postpartum women (within six weeks of delivery) from primary, secondary, and tertiary health facilities in Ondo State for quantitative data, using a validated structured questionnaire. Expectation disconfirmation was computed as the difference between expectation and experience ratings after 14 in-depth interviews were completed to reach data saturation. Descriptive statistics, chi-square tests, and binary logistic regression (SPSS version 25, p < 0.05) were used to analyse quantitative data. Qualitative data were subjected to thematic analysis. Results: Of 422 participants, 53. 8% had high expectations of maternity care, but only 54. 3% had overall positive experiences, indicating notable expectation disconfirmation, particularly in the postpartum period. Binary logistic regression showed that living in an urban area (AOR = 1.63, 95% CI 1.04- 2.10, p = 0.03) and higher education were independent predictors of positive experiences. Major influencing factors included professional support (81.8%), partner involvement (79.6%), psychological support (78.2%), personal expectations (75.8%), and continuity of care (73.9%). Qualitative themes centred on respectful interactions, facility environment and resource adequacy, professional and emotional support, partner involvement, and continuity of care/postpartum follow-up gaps. Quantitative predictors aligned well with qualitative stories, especially regarding rural-urban and educational differences. Intersecting socio- demographic, interpersonal, and structural factors shape maternity care experiences in Ondo State. Women-centred interventions that are context-sensitive and target expectation disconfirmation are urgently needed to improve satisfaction, skilled care use, and maternal health equity.
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