Table 2 Validated measurements used in client questionnaires

Bologna score [8]

To determine whether the intrapartum care in case of a normal birth was according to the best evidence.

5 items:

- presence of partner or friend during labour

- use of a partogram (measure progression objectively)

- absence of interventions

- labour not in supine position

- skin-to-skin contact between mother and child for at least 30 minutes during first hour postpartum

Q3

Dutch consumer quality index (CQI) treatment score [9]

To measure the actual experience of clients with structure and process aspects of health care, as well as the importance clients attach to each aspect.

6 items:

- Does your midwife treat you with respect?

- Do you feel that your midwife listens to you?

- Does your midwife devote enough time to you?

- Do you feel that your midwife takes you seriously?

- Does your midwife explain things to you in a way that is easy for you to understand?

- Do you feel you are in good hands with your midwife?

(options: never/sometimes/usually/always)

Q2 + Q3

Labour Agentry Scale [10]

To measure personal control during childbirth (separately during first and second stage of labour).

10 items (shortened version):

- I was tense

- I felt important

- I felt confident

- I felt I was in control of myself

- I was scared

- I was relaxed

- I felt I was doing a good job

- I felt helpless

- I felt powerless

- I felt I was surrounded by people who cared for me

- I felt a failure

(options: The whole time or nearly the whole time/About three quarters of the time/Just over half the time/About half the time/Just under half the time/About a quarter of the time/Not or hardly at all)

Q3

EuroQol questionnaire [11]

To measure health-related quality of life, categorized by mobility, self-care, main activity, social relationships, pain and mood.

6 dimensions:

- Mobility

- Self-care

- Main activity (eg work, study, housework)

- Social relationships (pursue family and leisure activities)

- Pain

- Mood (anxious or depressed)

Q1 + Q2 + Q3

Visual Analogue Scale [12]

To measure pain

10 cm visual analogue scale, from 'no pain' to 'worst pain imaginable'

Q2 + Q3