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Women happier with maternity care, national survey shows

But still much more to do on antenatal care choices

Caroline White

Wednesday, 31 January 2018

Women are reporting a more positive experience of maternity care and treatment, with most responses having improved or stayed the same since 2015, show the results of the fifth national survey of maternity services, published by the Care Quality Commission (CQC).

More than 18,000 women who gave birth in February 2017 in services run by 130 NHS trusts across the country were asked about their experiences of antenatal care, care during labour and birth, and postnatal care.

The 2017 results indicate improvements in areas such as choice of where to give birth, quality of information and access to help and support after the birth, compared to the results of previous years’ surveys.

The proportion of women who said they were offered the choice of giving birth in a midwife-led unit or birth centre has increased by 7% since 2013 (35% in 2013; 41% in 2015; rising to 42% in 2017).

Over a third of women (38%) reported that they saw the same midwife at every antenatal appointment— a 4% increase since 2013.

Most (88%) respondents said that they were ‘always’ treated with dignity and respect during labour and birth compared to 86% who said this in 2015 (85% in 2013).

Most women (77%) reported that they were never left alone during the birth of their baby at a time when it worried them. This compares to 74% in 2015.

Most respondents felt involved in decisions throughout their pregnancy. Most women (77%) were ‘always’ involved in decisions about their antenatal care and 80% were ‘always’ involved in decisions about their care during labour and birth.

But while more women reported being offered the choice about where to have their antenatal checks compared to previous years (29% in 2013 rising to 31% in 2017), over two thirds of women (69%) still said they were not given a choice about this aspect of their care.

Most people did not see the same midwife at each appointment, but many said that they didn’t mind this. But the women who saw the same midwife for all of their antenatal care and the same midwife for all of their postnatal care reported receiving more compassionate care than average.

In 2015 NHS England announced a major review of national maternity services. As part of this review, the Better Births report, published in 2016, outlined seven priority areas where improvements are needed. Personalised care was one of these priorities.

Professor Ted Baker, CQC’s chief inspector of Hospitals, said: “This year’s survey shows some very positive results about the quality of maternity care being provided in the NHS. This is a testament to efforts and dedication of staff working hard to provide care for pregnant women and new mothers across the country.

“However, the scope for continued improvement remains, particularly in relation to women’s choices about their antenatal care and ensuring enough information is available to support women through any emotional changes they might experience after giving birth.”

He continued: “Our own inspection work of maternity services so far shows that the majority of trusts are providing high quality care – with over 60 per cent of hospitals rated as either ‘Good’ or ‘Outstanding’ for maternity. However, this also highlights that further work is needed to narrow the variation that we know exists.”

Royal College of Midwives head of quality and standards, Mandy Forrester, described the results as “quite positive.”

She added: “Overall, the results indicate improvements in areas of maternity care since 2015, but there is still much more that can be done to ensure women are experiencing the best possible care and treatment during their pregnancy.

"In England we remain 3500 midwives short of the number needed to deliver safe, high-quality care and more investment in our maternity services is needed to help us achieve the best outcomes for both mother and baby.”

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