‘Concerning decline’ in women’s satisfaction with maternity services

A new survey has revealed a “concerning decline” in women’s satisfaction with UK maternity services, with fewer reporting positively about their experience of maternity care.

While satisfaction across many areas of maternity care remained high and some improvements were made, the survey reveals that in 2022, women struggled more to access information and support when it was most needed.

A significant decline in positive responses

The standard of care in maternity services across the UK has come under fire since the start of the pandemic, and in the first half of 2022, the Care Quality Commission (CQC) found that 39% of maternity units in England were providing substandard care to mother and babies.

Indeed, a number of damning reports which revealed suboptimal maternity care were published in 2022. One investigation into the maternity services at East Kent Hospitals University NHS Foundation Trust, for example, revealed that 45 babies (of 65 cases examined) may not have died if care had been given to a national standard.

Now, the CQC’s latest national maternity survey, which used data from more than 20,900 women who gave birth in February 2022, reveals further evidence of the poor standards of care for mothers and babies.

Out of the 26 questions asked, the CQC identified a significant decline in positive responses to 80% of the questions. For 10 of the questions, the responses were at their lowest since 2017.

Women not always able to access help from staff when they needed it

In 2022, fewer people (82%) said they were given appropriate advice and support when they contacted a midwife or hospital at the start of their labour compared to in 2017 (87%).

Furthermore, the number of women who felt they were ‘always’ given the information and explanations they needed while in hospital dropped from 66% in 2017 to 59% in 2022.

Many of the survey respondents also said they struggled to get a member of staff to help them when they needed attention during labour, birth and after birth. During labour and birth, less than two thirds (63%) said they were ‘always’ able to get help from staff compared to nearly three-quarters (72%) in 2019. After birth, the number was lower still at 57% compared to 62% in 2019.

The Covid-19 pandemic had a clear impact on women’s satisfaction with maternity services, with just 41% saying their partner or someone else close to them was able to stay with them in hospital (as much as they wanted), compared to 74% in 2019.

Lack of staff and resources contributing to poor maternity care

There were improvements in some areas, however, with the number of women who said they experienced no delay in their discharge from hospital rising from 55% in 2017 to 62% in 2022.

Mental health support also markedly improved, with nearly three-quarters (71%) saying their midwife asked about their mental health during antenatal check-ups compared with 69% in 2021 and 67% in 2019.

Even so, Victoria Vallance, CQC’s Director of Secondary and Specialist Care, said the survey’s results reveal “a concerning decline over time”, with “far too many women [saying] their care could have been better”.

Ms Vallance says the results reflect “the increasing pressures on frontline staff as they continue in their efforts to provide high quality maternity care with the resources available.”

“It also echoes what maternity staff attending CQC’s roundtable event last year told us about the exceptionally demanding circumstances in which they are operating and the need for greater support to help manage the challenges they face,” she added.

The CQC says it hopes that trusts will use their individual surveys to create the change that is needed on the ground. The Commission has also created a new programme of maternity inspections so it can share good practice examples to trusts and support learning and improvement.