Date Published: 20 March 2007
UK National survey reports on women's experience of maternity care
The results of the first national survey of recent mothers in a decade are published today at www.npeu.ox.ac.uk. The survey, by the National Perinatal Epidemiology Unit (NPEU) at the University of Oxford, found that while the majority of women are happy with the care they receive there are important aspects of care that still do not align with national policy and standards.
Nearly three thousand recent mothers across England responded to the survey, conducted in 2006, giving their views on the care and information they received through pregnancy, birth and postnatally, both in hospital and at home.
Although almost half the women surveyed had antenatal care provided exclusively by midwives. Most women saw their GP when they first realised they were pregnant; only a minority of women (13%) went directly to a midwife, despite this being national policy since 2004. Changing patterns of antenatal care since 1995, in line with national guidelines, were evident, with women accessing maternity care earlier in pregnancy, but having fewer antenatal appointments overall.
Over a third of women only had the option of going to one hospital for the birth of their baby, but the number being offered home birth has risen significantly since 1995, with more than one third now saying that they had this option at the start of pregnancy.
The survey indicates that the caesarean section rate has risen from 17% in 1995 to 23% in 2006. Less than 2% of the women who had had caesareans stated that they chose to have a caesarean without indicating any clinical reasons.
Care from doctors and midwives was praised by the vast majority of women, although around one quarter had mixed views about the care they received and were not wholly positive. Around one in ten women felt that staff did not communicate well with each other during labour and birth. While more than three-quarters of women described their carers at this time as ?supportive”and ?kind?, some said that the staff were ?rushed”(16%) and ?bossy”(12%).
One section of the report examines the care received by four specific groups: women from a Black and Minority Ethnic (BME) background, BME women born outside the UK, women living in the most deprived areas and single women. The findings suggest that women from these groups were more likely to access maternity services later, more likely to report feeling they were not always treated with respect by their carers and that they were not always spoken to in a way they could understand compared with other women. Further analyses are planned to explore the way that possible disadvantage affects women's access to and experience of maternity care.
The survey, funded by the Healthcare Commission, the Department of Health and The Information Centre for Health and Social Care, builds on a previous national survey of the same type conducted for the Audit Commission in 1995 and analysed by the NPEU. Changes since 1995 are examined in the report, together with comparisons of the experience of women having a first or subsequent baby.
The survey provides an up-to-date picture of maternity services, a point of comparison with other surveys, including the Healthcare Commission's forthcoming Trust-level survey of women's experience of maternity services, and a baseline against which to compare future developments, and will be used by the NPEU in future research work on quality and outcomes of maternity care in England.
Maggie Redshaw from the NPEU, one of the report's authors, said:
" By collecting data on clinical care, as well as on women's individual experiences, we have been able to provide a more complete picture of women's perspective on care in pregnancy and childbirth.
_ Maternity care workers, policy makers, commissioners and health professionals can reflect on the findings of the survey which come directly from mothers themselves.
_ This survey gives a message to those designing services and caring for women during the birthing process that they are in a powerful position to make a difference to that care."
Source: Oxford University.