Step this way to help shape the future of maternity services in England

[RowanMumsnet]

Hello

As some of you will know, Mumsnet is on the panel of the National Maternity Review, which is an NHS England initiative set up in the wake of the report into the deaths of mothers and babies at the Morecambe Bay hospitals trust.

The remit of the review is to 'assess current maternity care provision and consider how services should be developed to meet the changing needs of women and babies'.

So we'd be really grateful if you could give us your feedback on the following two very broad themes:

Which choices do you wish to be able to make about the maternity care you receive?

What are the key barriers preventing women from making the choices that they wish to?

Thanks - any and all thoughts welcome. (And just FYI, this won't be your only opportunity to feed in, and more detailed feedback systems are going to be launched soon - we'll flag these up as they happen.)

Thanks icebeing
I think so, so far anyway. I have been quite emotional but I don't think it helps when every person that visits asks about the birth (as people always do) and it sets me off. I have suffered from depression and had panic attacks in the past so DH is keeping his eye out for signs of me not being myself.

Sorry to hear you are finding it difficult. Its good that you have your DH on the case. Best wishes for the future - and feel free to punch anyone who even hints you should just get over it.

Thanks IceBeing and for Scorpio - best wishes from us at MNHQ.

I brought up the issue of data collection and publication with some people recently and was directed to the stats area of the Which? Birth Choices site. Anyone fancy having a play and letting us know whether the stats on here broadly cover the areas you're concerned about?

Thanks

I might be being stupid but I couldn't actually see what stats this was providing. I wanted to check what fraction of planned C-sections were for medical reasons but couldn't find the number for instance.

A major flaw I picked up on immediately was that it talks about risks of physical damage during childbirth but not mental damage. eg. What is the rate of PTSD on planned C-sections versus not?

Which choices do you wish to be able to make about the maternity care you receive?

I had the choice of local hospital, although no one mentioned anything about birthing centres etc at the start of my care. I was low risk initially, so it should have been an option, but it wasn't discussed.

I wasn't given much information during actual labour about how my labour was progressing - my son was back to back, and despite me saying I thought something was wrong from early on, and them not being able to keep a trace on him, they didn't actually explain what was going on until they insisted I was put on the syntocin drip. I'd asked to be kept informed all along, and according to my notes they'd known for a good while.

I would also have liked a more experienced Midwife - I had a recently qualified midwife for most of my labour, and it wasn't until she was relieved at the end of the shift and the more experienced midwife took over that I was told there was a problem and we needed to get things sorted asap (a dr was called and I was prepped immediately for a c-section, but fortunately forceps worked) I dread to think what might have happened if she'd been working later. I've nothing against newly trained medical staff - I know they have to learn, but when a problem arose she didn't do anything about it - I know now that perhaps I could have asked for someone else, but again this isn't something that is discussed.

What are the key barriers preventing women from making the choices that they wish to?

A lack of information - we don't know what we can and can't say no to, and when we're in a vulnerable position anyway it can be difficult to get across what we want. There needs to be more transparency.

I also got the impression I was "taking up their time" by having a long labour (hence the syntocin). Despite me making it abundantly clear from the offset that I struggle with anxiety, no one listened, which made me feel less like I could talk to anyone. It is made obvious from the start that the hospitals are more concerned with the baby than the mother, which puts mother in an awful position. I was made to feel like a bad mother before I left the labour ward - what a great way to start family life!

Rowan - I'll do a review of the stats on which. I've used them before but I think some things are missing. I'll post it up here in a few days if that's okay?

Review of the Which website coming up....Sorry its long!

I'm not a midwife or anything. Just a woman who's had one baby and is starting to think about birth settings for my second.

For me the priorities for DCs birth are: 1) Safety of mother and baby, 2) Positive experience for me (being given information, having my choices supported and being included in decision making), 3) Interventions should be done as needed and only as needed (no reluctance to intervene if necessary and equally no unnecessary interventions. Given those priorities here are the bits of the Which website that are useful and the data that I feel is missing:

1. Safety of mother and baby – The info on ‘cut and tears’ is a good start. However, Calderdale & Huddersfield birth centres have 0% cuts and tears? This info is useless to me as clearly inaccurate.

Birth injuries - A stat on birth injuries to mother and baby and whether these has short or long term health implications would probably be the most useful stat you could give for me to understand safety at my local settings

Average Transfer time – A stat giving the average transfer time over the past year would be useful for birth centres particularly freestanding birth centres as this is a big safety concern (so how long did it actually take women to get to an obstetrician from decision to transfer to handover of notes). The transfer time on the Which website appears to be best case scenario which could be very different to the reality.

2. Positive Experience – I think the only way for me to understand how well women in labour are treated at each setting is for women to rate the hospital and to get comments from women. In my area (Calderdale) there are very few comments from women and they are all very old so they are not useful to me. I think Which need to be more proactive in seeking out womens opinions. We have newborns,. We are very busy. We are very unlikely to go onto a website and write comments off our own backs.

3. Interventions as needed and only as needed - I can easily find out which maternity unit near me has a low induction, c section and assisted delivery rate. I can also guess which maternity units might be more supportive of Elcs or vbac based on stats. However, I am not against interventions if they are necessary for the health of me or my baby and i certainly don’t want reluctance or delays to interventions if there is any danger to my baby or me. In this respect the Which stats don’t help me very much. This would probably need to come from women rating or commenting on the website. It would also maybe be helpful to know the percentage of high medium and low risk women that birth at each setting. As any setting which doesn’t take high risk women would always have a lower c section rate.

The ‘Best Choice for you’ tool they provide is really great! The info about facilities etc are brilliant and the data provided is a great start and far more comprehensive and accessible than anything else I’ve seen but would be much more useful if they could address some of the gaps above.

Thanks very much for the Which? feedback - really useful.

We also wanted to flag up the #MatExp website for any of you who'd be interested in reading/sharing more on this topic (beyond MN). MatExp is a group of clinical professionals and service users who are aiming to share experiences and ideas for improvements in maternity services. You can find their site here and the hashtag to follow on social media is #MatExp.

Thanks
MNHQ

Hello again

The consultation is now open - do please take a look and feed in your views.

Thanks
MNHQ