The Care Quality Commission’s latest national survey of more than 20,000 women suggests that most expectant and new mothers are experiencing better maternity care than in recent years.
The survey involved women who gave birth in February this year across the 133 NHS trusts in England. It found overall they had a better experience overall, compared to the results from previous years.
“I am glad that the findings suggest women are experiencing better care and treatment during pregnancy and birth”
Access to midwives, choice of where to give birth, and the quality of information are particular areas where the NHS appears to have improved, said the CQC.
The findings, published today, highlight women’s responses to questions across themes such as access to care, personal choices, type of birth and emotional wellbeing.
The responses indicated they have had positive experiences as a result of being first seen by a midwife, being offered a midwife-led unit and always being spoken to in a way that is understood.
Being treated with dignity and respect, having clean wards, toilets and bathrooms and more support for feeding also featured favourably in the survey responses, said the regulator.
The research is the fourth survey of its kind that the CQC has carried out in order to help trusts understand what women’s experiences are of their maternity care and to make improvements.
Professor Sir Mike Richards, the CQC’s chief inspector of hospitals, said: “Every single woman deserves to be treated with dignity and personalised care when having a baby, and so I am glad that the findings suggest women are experiencing better care and treatment during pregnancy and birth.
Sir Mike Richards
“The survey identifies some examples of encouraging data trends showing improvements across a number of areas, and reinforces the importance of NHS trusts focussing on women’s individual needs and choices,” he said.
“From our own inspection work of maternity services so far – rating just over 60% of trusts as either ‘good’ or ‘outstanding’ – there is no doubt of the improvement work that is still needed in order to narrow the wide gap of variation that we know exists,” said Sir Mike.
The CQC’s latest annual State of Care report, published in October, stated that 2% of maternity units in acute hospitals had been rated as “outstanding”, 60% are “good”, 34% are “requires improvement” and 4% are “inadequate”.
Sir Mike added: “I hope NHS trusts will make full use of their individual survey results so that they can translate the delivery of maternity services into consistent and high-quality care for the benefit of all women and their families.”
“It is deeply concerning to see that women are still being left alone in early labour”
The CQC said it was studying the survey findings further before publishing an official report on them in the new year, which will provide more analysis and opinion across each of the five key areas that the CQC inspects against.
Royal College of Midwives director for midwifery Louise Silverton said: “The survey results are positive and indeed suggest overall that women are experiencing better care during pregnancy and birth.”
“The results indicate a good improvement since 2013, but there is still much more that can be done to ensure women are experiencing the best possible care and treatment during their pregnancy,” she said.
Ms Silverton stated: “It is deeply concerning to see that women are still being left alone in early labour. While almost a quarter of the women surveyed said they were left alone and were bothered by this, at some stage during their labour and this is simply not expectable in 2015.”
She added: “The increase in the numbers of women giving birth in water and off the bed is to be welcomed, with 16% of women being able to adopt different positions.
”The apparent increase in the numbers of women reporting giving birth in stirrups is puzzling. These will include all those women who had instrumental (forceps) or vacuum assisted births,” she said. ”Those women having unassisted vaginal births would not normally do so in stirrups but they will be used for the repair of any episiotomy or perineal tear.”
“Continuity of care and carer has also improved and this year’s findings show that there has been an increase in the number of women who said that they saw the same midwife at every antenatal appointment and this is something the RCM believes is crucial and everyone women deserves,” noted Ms Silverton.
Notable trends from this year’s statistical report:
- The proportion of women who reported that the first healthcare professional they saw about their pregnancy was a midwife has nearly doubled in the last eight years – around two fifths (37%) reported this in 2015, up from around a fifth (19%) in 2007 (32% in 2013)
- 59% of women in 2015 said they received their first ‘booking’ appointment before they were 10 weeks pregnant, compared to 37% in 2007
- 41% of women said they were offered a choice of giving birth in a midwife led unit or birth centre; a 6% increase from 2013 (35%)
- Over a third of women (36%) reported that they saw the same midwife at every antenatal appointment, 2% more than in 2013, although 35% this year said they did not mind
- 89% of women said that during their antenatal care they were “always” spoken to in a way they could understand – up by 7 percentage points since 2007 (82%). However, this means that 11% were not “always” spoken in this way
- Nearly two thirds of women (62%) said they felt they were “always” given the information or explanations they needed whilst in hospital and after the birth of their baby; an increase of 3 percentage points compared to 2013 (59%)
- Support during and after pregnancy has considerably improved rising from 42% in 2007 to 63% of women in 2015 saying they felt that midwives and other health professionals gave active support and encouragement about feeding their baby
- 87% of women reported that they were always treated with dignity and respect during labour and birth compared to 85% in 2013
- The proportion of women being in a position of lying with legs in stirrups whilst having a normal vaginal delivery has seen a steady increase over the past few years going from 17% in 2010, to 19% in 2013 and 22% in 2015