The views of over 17,000 women about their maternity care have now been published. The 2019 CQC Maternity Survey results demonstrate women continue to report positive experience of their care across the maternity pathway and that their experience is getting better - with statistically significant improvements seen between 2018 and 2019 across most comparable questions. There was an improvement in the national score of 22 of the 29 questions in the survey used by CQC to benchmark trust performance; just two questions showed a deterioration.
A four-year progress review document of Better Births has also been published: https://www.england.nhs.uk/publication/better-births-four-years-on-a-review-of-progress/. Well done to Better Births Lincolnshire who got a special mention on page 40 in recognition of their work opening community hubs in Children’s Centres in Skegness and Mablethorpe.
A summary of he CQC survey results is below.
Safety
When asked about their labour and birth:
• 84% of percent of women responded that if they raised a concern during labour or birth it was taken seriously, up by 2.5 percentage points since 2018 (82%).
• 78% of women reported that they (and / or their partner or a companion) were not left alone at all at a time when it worried them during labour, birth or shortly after birth. This is up by 1.4 percentage points since 2018 (77%).
Personalisation & choice
When asked about their antenatal care:
• 82% of women responded that they were ‘always’ involved in decisions about their care during antenatal check-ups. Only 2% of women responded that they were not involved.
• 79% of women reported that they were ‘always’ given enough time to ask questions or discuss their pregnancy during antenatal check-ups, up by 2.4 percentage points since 2018 (77%).
• 71% of women said they were offered antenatal classes or courses provided by the NHS; this was the first time this question was asked.
When asked about their labour and birth:
• 89% of women responded that they were ‘always’ treated with respect and dignity, up by 1.4 percentage points since 2018 (88%).
• 84% of women responded that they ‘definitely’ had confidence and trust in the staff caring for them, up by 1.4 percentage points since 2018 (82%).
• When asked about their pain relief during labour, 38% of women responded that the pain relief they used changed from what they had originally wanted, mainly for reasons linked to the characteristics of the labour labour e.g. the type of pain relief not being effective or women not requiring pain relief. However, 3% of women whose pain relief changed reported that an anaesthetist was not available to provide their chosen pain relief and 4% responded that they were not told why they could not have their chosen pain relief.
• 37% of women reported that they gave birth lying down with their legs in stirrups, this figure has risen since 2013 (when it was 32%). 24% of women who reported that they had an unassisted vaginal delivery gave birth with their legs in stirrups.
When asked about their stay in hospital after the birth:
• 74% of women responded that their partner or someone else close to them could stay with them in hospital after birth as much as they wanted. This was up by 2.9 percentage points since 2018 (71%).
When asked questions related to feeding their baby:
• 69% of women responded that they were given active support and encouragement about feeding their baby, up by 6.1 percentage points since 2018 (63%).
Women being listened to
• 84% of women reported that they were ‘always’ listened to during their antenatal check-ups, up by 1.3 percentage points since 2018 (82%) and 4.0 percentage points higher than 2013 (79%).
• 84% of women responded that if they raised a concern during labour or birth it was taken seriously, up by 2.5 percentage points since 2018 (82%) and 4.0 percentage points higher than 2013 (80%).
• 79% of women reported that they were ‘always’ listened to during their postnatal care at home after the birth.
Continuity of carer
• 9% of women were cared for postnatally by a midwife who had also been involved in their care antenatally and during labour and birth.
• 52% of women reported that the team of midwives were always aware of their medical history at antenatal appointments. This is up by 2.5 percentage points since 2018 (50%), however, 12% of women reported that their midwives were not aware of their medical history.
Perinatal mental health
• 67% of women responded that they were ‘definitely’ asked about their mental health by their midwife during antenatal appointments.
• 95% of women were asked about their mental health by a midwife or health visitor after leaving hospital following the birth of their baby.
• Women were asked if, during their postnatal care at home, they had been given information about any changes they might experience to their mental health after having their baby: 25% of women reported that they only received this information ‘to some extent’ and 12% reported that they did not receive this information.
GP postnatal appointments
• 30% of women reported that the GP did not spend enough time talking to them about their mental health. A similar proportion of women (29%) reported that this was the case when asked if the GP had spent enough time talking to them about their physical health.
New questions
For 2019, several new questions were added to reflect current policy priorities around choice, the availability of antenatal classes, and the GP postnatal check.
Background information
This publication presents the results of the 2019 survey, which had a sampling month of February (and January for smaller NHS trusts), with fieldwork from April to August 2019. The survey involved 126 NHS trusts[1] in England. The survey response rate was 36.5%, based on over 17,151 responses. The survey last took place last year.
The results of 11 questions in the survey will also inform the following two maternity indicators in the NHS Oversight Framework for 2019/20:
• Women’s experience of maternity services
• Choices in maternity services
A statistical summary of the underlying survey data has been published by the Care Quality Commission (CQC) and can be found at: https://www.cqc.org.uk/publications/surveys/maternity-services-survey-2019 national tables and NHS trust level data can also be found on CQC’s website.
Individual NHS trust results for each stage of the maternity pathway can be found here: https://nhssurveys.org/all-files/04-maternity/05-benchmarks-reports/2019/
