Pregnant women want better care

Jayne Howarth and Stacey Collins Care of women giving birth and the months before birth still needs improvement in England - although care after a baby is born may be getting better. Those are the findings of a major - and official - survey of new mums published only yesterday. The Care Quality Commission is the body responsible for overseeing quality in English hospitals. It questioned thousands of new mothers in England about their experience of having babies. It found that 52 per cent of them believed they received sufficient help and advice from health professionals in the six weeks after birth about feeding their baby. This compares with 56 per cent in 2007, when the CQC carried out its last survey. The findings gained mixed reactions. The National Childbirth Trust, which speaks for many parents, said it showed no overall improvement. Nearly one in five women said they did not receive enough information about their recovery, while 21 per cent said they were not given sufficient insight into emotional changes they might experience following the birth. CQC chief executive Cynthia Bower highlights these issues as helping  parents care for their new baby, and were particularly relevant as the average length of stay in hospital is reducing. Approximately 25,000 mothers of newborns were asked about all aspects of their maternity care from the first time they saw a clinician, to care provided at home in the weeks following the birth of their baby.

Key findings were:  53 per cent of women had a booking appointment before nine weeks, up from 37 per cent;  83 per cent were offered a choice of where to give birth and 74 per cent were offered a home birth; 95 per cent had a dating scan, up from 89 per cent; Sixty five per cent said they “definitely” received the pain relief they wanted, up one per cent, although eight per cent reported they did not have the pain relief they wanted, which is unchanged from 2007;  Excluding women who had assisted deliveries, 38 per cent gave birth lying down and a further 17 per cent were supported with stirrups, an increase from 14 per cent. This contradicts NICE guidance, which discourages using these positions unless clinically necessary; 17 per cent said they had not had any discussions with maternity staff about infant feeding; Of the women who had contact details for a midwife during the antenatal care, 28 per cent said the help received was inconsistent or no help was received at all; 22 per cent of women said they were left alone by staff during labour or shortly after the birth at a time when it worried them, down four per cent.  Belinda Phipps, of the National Childbirth Trust, said: "What is clear from this survey is that women's experiences are not improving overall. Too few women are being offered choice, women are still being left alone in labour and more information and support is needed." She said it was good news that more women report being treated with "kindness and understanding". Cathy Warwick, general secretary of the Royal College of Midwives, said more progress was needed - although the report was "encouraging". She said: "The increase in the number of women seeing a midwife first is particularly welcome. However, some of the findings show that there is still much to do, in areas such as the provision of antenatal education, high quality care in labour and ensuring appropriate advice and support in the postnatal period." Dr Tony Falconer, president of the Royal College of Obstetricians and Gynaecologists, said: "The survey still highlights the need for changes in postnatal care, in particular support for breast feeding and the early detection of significant emotional or psychological changes experienced during the postnatal period. "This underlines the necessity of having appropriately trained professionals readily available at all stages of pregnancy." Ms Bower said: “This reported improvement in antenatal care is encouraging, but sadly it is not mirrored in the care provided during labour and birth. “There have been few improvements in postnatal care, with worryingly fewer women saying they receive the information or explanations they need. “New parents need to feel reassured at this particularly important time in their lives as they embark on parenthood.” * Do these findings ring true? What's your experience?