More than 18,000 women have responded to the Maternity Survey 2017, which is the biggest source of data on people’s experiences of maternity care in England. The results come at an interesting time; in 2015 NHS England announced a major review of national maternity services. As part of this review, the Better Births report (2016) outlined seven priority areas where improvements are needed.
Personalised care was one of these priority areas – and the survey shows mixed experiences of this at different stages of pregnancy. There was room for improvement in the information given to help mothers decide where to have their babies: although 59% said they “definitely” received enough information, this leaves two in five who would have liked more. Almost one in six (15%) said they were not offered any choices about where to have their baby – and whilst this is an improvement from a figure of 18% in 2013, it still leaves too many women without a say in a life changing decision.
Care during the labour and the birth, however, generally included good communication. Nearly nine in ten (89%) said that they were “always” spoken to in a way they could understand, and three-quarters (77%) said they were ‘always’ given enough time to ask questions or discuss their pregnancy. This has increased since 2013 (74%) and 2015 (75%).
Overall, 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.
Continuity of care is another priority area identified in Better Births. The survey asked women whether they saw the same midwife throughout their pregnancy as one means of measuring continuity of care.
Most people did not see the same midwife at each appointment – but many said that they did not mind this. While over 60% of respondents (61%) did not see the same midwife for all of their antenatal check-ups, half (56%) of these women didn’t mind this. Also, 72% did not see the same midwife for all of their postnatal appointments but 65% of these women didn’t mind this. That many respondents did not mind seeing different midwives suggests that having appointments with different professionals still resulted in generally good experiences. However, it was striking that 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.
Chris Graham, CEO of Picker, concluded: “Better Births (2016) has a welcome focus on personalisation and continuity of care. These are two elements that are really important to people who use health services. The Maternity Survey 2017 shows some strong progress against both of these areas, alongside encouraging results on other subjects that are a high priorities for families such as clear communications (particularly in relation to during labour and birth) and involvement in decision making.
The results highlight that people who are able to see the same midwife across their care are likely to have better experiences of compassionate care – which emphasises the value of good relationships with trusted professionals. However, reported shortfalls in the number of midwives nationally mean that it is challenging to provide this level of personal continuity in all cases. The challenge for providers is to ensure that the same standard of personalised support can be provided by well coordinated teams who are able to collectively deliver continuity of care. The detailed survey results provide valuable local information about where this is going well, and we encourage all trusts to review their own findings and work with patients and families to deliver the best possible services.”