Notes on a stick: use and acceptability of woman-held maternity notes

ObjectiveTo provide expectant mothers with a USB stick containing their maternity notes, including ultrasound images, and to assess its use and acceptability versus conventional care with exclusively hospital-held notes.Study designUSB group: 200 women attending Zurich University Hospital Obstetrics Department for antenatal-to-postnatal care in 2006–2007. Controls: 200 women attending the Obstetrics Department for delivery only, after receiving conventional antenatal care elsewhere. Women were interviewed using an essentially identical postpartum questionnaire for each group, with minor wording differences. Main outcome measures: Overall satisfaction with pregnancy and delivery, feeling of safety, interest in the pregnancy, partner involvement, usefulness of USB stick in emergencies, impact on smoking behaviour, data confidentiality concerns, pregnancy and infant outcome. Stepwise multiple regression was used to identify determinants of overall impressions of pregnancy and delivery.ResultsOf the USB group, 98.5% wished to repeat the USB experience in a subsequent pregnancy; of the controls, 86.5% would have appreciated the experience, and 18.0% could think of situations in their pregnancy (vacation, emergencies) where the stick would have helped; 7.5% of the USB group shared their stick data with a doctor outside the Department, and 80.5% felt safer having the stick available. Along with preterm delivery and mode of delivery, the USB stick was a significant determinant of the overall positive impression of pregnancy. Primary caesarean section was (inexplicably) more frequent in the USB group.ConclusionThe questionnaire confirmed that issuing women with their maternity notes on a USB stick is a major advance in patient empowerment, satisfaction and safety.