February 8, 2023

Pregnant women and new mothers are increasingly being let down by the NHS and many are losing confidence in maternity care, a damning report has found.

A large survey of 20,900 women by the care regulator showed that the number of positive experiences with pregnancy, childbirth and postnatal care has fallen sharply.

There is a particularly worrying drop in the proportion able to get help from staff when they need it compared to five years ago, the Care Quality Commission says.

Nearly four in ten women struggled to get staff to help them during labour, and more than half were not always able to get advice on nutrition after being sent home.

A large survey of 20,900 women by the Care Quality Commission found that the number of women reporting a positive experience of pregnancy, childbirth and postnatal care has fallen sharply. Pictured: Rhiannon Davies of Ludlow, Shropshire with her daughter Kate shortly after she was born on 1 March 2009 at Shrewsbury and Telford NHS Trust. Kate died a few hours later

The findings come after a series of NHS pregnancy scandals in which dozens of mothers and babies have died or suffered serious harm.

Inspections have also found that more than half of maternity units do not meet safety standards, with two in five rated as ‘needs improvement’ or ‘inadequate’ overall.

Only 69 percent of women always got the help they needed when they contacted a midwifery team during antenatal care last year, down from 74 percent in 2017.

The likelihood of them always getting staff to assist them during labor and delivery was even lower at 63 percent – down from 72 percent in 2019.

Another major study of NHS maternity care is currently underway at Nottingham University Hospitals.  The final report is expected in March 2024

Another major study of NHS maternity care is currently underway at Nottingham University Hospitals. The final report is expected in March 2024

Tracey Fletcher, Chief Executive of East Kent Hospitals, issued a statement following the release of Dr.  Bill Kirkup on deficiencies in maternity care and treatment of mothers and babies at East Kent Hospitals University NHS Foundation Trust

Tracey Fletcher, Chief Executive of East Kent Hospitals, issued a statement following the release of Dr. Bill Kirkup on deficiencies in maternity care and treatment of mothers and babies at East Kent Hospitals University NHS Foundation Trust

‘Deplorable and harrowing’: the pregnancy scandals that rocked the NHS last year

The findings come in the wake of multiple reports of poor maternity care in England.

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A review of serious shortcomings will be added in October East Kent Hospital Trust found that at least 45 babies died needlessly due to “catastrophic” and “deep-seated” care failures.

Affected families described being ‘neglected, belittled and blamed’, with mothers feeling guilty for tragic incidents.

Dr. Bill Kirkup, who led the investigation, called for a new law so organizations can be prosecuted for covering up future tragedies.

Meanwhile, a five-year study, published last March, found that 201 babies and nine mothers died needlessly during two decades of appalling hospital care. Shrewsbury and Telford Hospital NHS Trust.

The research examined cases involving 1,486 families, mostly from 2000 to 2019, and found that ‘repeated mistakes in care’ had resulted in harm to mothers or their babies.

Findings from another NHS pregnancy scandal are also likely to be published in the next 18 months.

Ms Ockenden, the midwife behind the damning Shrewsbury and Telford report, is currently leading an investigation into reports of poor care for mothers and babies in Nottingham University Hospitals NHS Trust.

The new investigation began in September and will examine events from April 2012 to the present.

At least nine babies and three mothers are said to have died in the past three years at the trust, which runs 15 hospitals in the Midlands.

And standards were even lower after birth: only 57 percent always got the support they needed in hospital, down from 62 percent in 2019.

The survey, conducted last January and February and published today, shows that many women continue to be abandoned after returning home.

After giving birth, only 70 percent always got the help they needed to contact a midwife or health visitation team, down from 79 percent in 2019.

And less than half (45 percent) said they could always get support or advice about feeding their baby in the evening, at night or on weekends – up from 56 percent in 2017.

Women who had an unassisted vaginal delivery and who regularly saw the same obstetrician were more likely to report positive experiences.

Those who had not previously been pregnant or had had a caesarean section tended to be less satisfied.

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The lack of availability of staff seems to have eroded women’s confidence in maternity care in recent years, and comes as the NHS struggles with a shortage of around 2,000 midwives.

Overall, just over two-thirds (69 percent) of those surveyed said they “definitely” have “trust” in the staff who provide their antenatal care.

The results were higher for staff involved in labor and delivery at 78 percent, but this is down from 82 percent in 2017.

The number of women who felt they were ‘always’ treated with kindness and understanding in hospital after giving birth also fell, from 74 percent to 71 percent over this period.

Victoria Vallance, CQC’s Director of Secondary and Specialized Care, said: ‘These results show that far too many women feel their care could have been better.

“The trend analysis done this year shows a worrying decline over time, especially with regard to accessing information and getting support and help when it was most needed.

“This reflects the increasing pressure on frontline staff as they continue their efforts to provide high quality maternity care with the resources available.

“It is vital that we listen to those who use and work in maternity care to understand what makes a good experience and what needs to be improved.”

The CQC analyzed trends for 26 questions between 2017 and 2022 and found that women’s caregiving experiences have worsened over the past five years.

Of these questions, one showed a statistically significant upward trend, four showed no change, and 21 showed a statistically significant downward trend.

In addition, the 2022 results of the 21 questions trending downwards were at their lowest point for the five-year period in ten cases.

The results for 18 of these questions dropped during the height of the pandemic in 2021.

Of the 18 questions where experience fell sharply in 2021, five saw a further decline in 2022 and six remained at the same level as in 2021.

The CQC said: ‘This indicates that some maternity care experiences have not yet recovered to pre-pandemic levels, including care during labor and delivery and postnatal care at home and in hospital.’

Interestingly, less than half of those surveyed (41 percent) said their partner or someone close to them could stay with them as much as they wanted during their hospital stay last year.

This was an increase from the 34 percent who said so in 2021, but the results were still well below the pre-pandemic level of 74 percent in 2019.

The survey revealed some improvements in recent years, with fewer women being delayed in hospital discharge last year and an increase in questions about their mental health during appointments.

Matthew Jolly, national clinical director for maternity and women’s health at NHS England, said: ‘The results of the CQC survey show the continued impact of the pandemic on maternity care, and while the majority of women were positive about their interactions with staff and the information provided, other findings show the implications of ongoing staffing challenges and reinforce the need for further improvements to maternity care.

“We continue to take action to strengthen maternity care services across the country – investing £165 million annually to grow our workforce, strengthen leadership and improve culture, while continuing to work closely with NHS trusts and our partners to make necessary improvements and ensure that we provide the best possible service to mothers, babies and their families.’

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