Encouraging improvements in maternity services but still work to do, says RCM
The findings of CQC’s latest annual national maternity survey capture what women who gave birth in February 2024 felt about the care they received while pregnant, in hospital during and after labour, and once at home in the weeks following the arrival of their baby.
This year’s results show that more women were asked about their mental health during antenatal check-ups compared to last year and that there has been steady improvement seen in this question area over the past five years.
More than three quarters (76%) of respondents said they were ‘definitely’ asked about their mental health during antenatal check-ups compared with 75% who said this in 2023. A large majority (93%) of respondents also reported that a midwife asked them about their mental health during their postnatal care.
Having access to enough support for mental health during pregnancy has also improved. Eighty-nine per cent of people surveyed said they received mental health support as part of their antenatal care compared with 88% in 2023, and 85% in 2022.
Many people continued to report positively about their interactions with maternity staff while pregnant. Most of those surveyed (83%) said that their midwives ‘always’ listened to them, that they were ‘always’ spoken to in a way they could understand (88%), and they were ‘always’ treated with respect and dignity (87%). A similarly large proportion of respondents (80%) said they were ‘always’ involved in decisions about their antenatal care.
The Royal College of Midwives (RCM) says it is pleased to see an increase in the levels of perinatal mental health support and in other areas, elevated levels of satisfaction from women who said ‘midwives always listened to them’ and ‘always’ shared clinical information with them in a way they understood.
Calls came from the Care Quality Commission (CQC) for national action, which the RCM said it supports, particularly the CQC’s ask of additional capital investment to support staff to deliver high quality care, which is something the RCM has long campaigned for. Ensuring services have the right staff in the right place, at the right time, with the right education and training, the RCM says, has never been more important given the increase in more complex pregnancies.
RCM’s Director for Maternity Reform Abbie Aplin said: “It’s really encouraging to see the experiences of women using maternity services are improving, but there’s still much work to do to ensure everyone using our maternity services is getting that gold standard of high quality care. During pregnancy and up to one year after birth, one in five women will experience mental health issues, ranging from anxiety and depression to more severe illness. Midwives and MSWs [maternity support workers] play a vital role in identifying the signs of poor mental health and supporting women who experience it during pregnancy, so it’s really positive to see women are getting this vital support when they need it. However, it is disappointing that some women reported poorer experiences during labour and birth, with a five-year downward trend in the number of people reporting that they were ‘always’ able to get help from staff during labour and birth.
“We know that maternity services up and down the country are struggling with staffing levels, and sadly this is a stark reminder of what can happen when you have too few staff. Our own members tell us that they often struggle to give the high standard of care they want and know they can deliver due to midwifery staffing pressures.”
The RCM says it is disappointed that women who reported their ethnicity as Indian, Pakistani and ‘any other white background’ reported poorer experiences. Last month the RCM launched Decolonising Midwifery Practice, which follows the RCM’s Decolonising Midwifery Education toolkit launched in 2023 that aims to ensure the midwifery curriculum educates midwives to provide outstanding and safe care to those from all backgrounds.
Aplin added: “The RCM is focusing on decolonising both the education and practice of midwives and all maternity staff because we believe positive change is urgently needed to improve the maternity experiences of women from the global majority. However, this requires a multi-agency approach. We also need specialist midwives in the right places to provide that specialist support and care that women from majority ethnic backgrounds so often need.”
The national survey shows better mental health support for pregnant women and new mothers.
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