98 Chapter 4 The high satisfaction rates are promising in terms of VBHC. To establish this, it is also important to determine the cost effectiveness.15 An economic evaluation of this innovation may provide valuable information about potential reductions in healthcare costs. Based on our results, implementing aCTGs in midwife-led care could benefit continuity of care and improve women’s satisfaction levels. In terms of further research, it is important to explore the facilitators and barriers for broader implementation. CONCLUSION This study shows that women are highly satisfied with aCTGs received in midwifeled care. Improving the level of comfort during the aCTG consultation may lead to even higher satisfaction scores for pregnant women receiving an aCTG in primary midwife-led care. In terms of women’s satisfaction levels, performing aCTGs in primary midwife-led care, thereby improving the continuity of care, seems to be a valuable change in the organization of maternity care in the Netherlands.
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