Our position on maternity care
In recent months there have been several well-publicised reports on maternity care which have highlighted consistent service failures, including the Ockenden review at Shrewsbury and Telford Hospital NHS Trust and most recently in East Kent. There is also broad acknowledgement that maternity issues are likely present in many services across the country.
These reviews and investigations, as well as our evidence, all point to a need to listen better to patients and ensure services are learning from incidents.
What we're calling for:
- Improved listening to patients and their families, who should be at the heart of transformational plans for the future delivery of maternity care.
- A renewed emphasis on staffing to ensure safe and high-quality maternity care.
- Clear pathways to mental health support for new mothers, and improved delivery and take-up of six-week mental health checks.
- A more family focused approach to maternal mental health and wellbeing, including fathers and partners.
- Greater emphasis on support for those who have been through a traumatic labour or pregnancy experience.
- Emphasis on addressing racial disparities in maternity services.
Our evidence
Many women are not getting maternal mental health support that meets national guidelines
In September 2019, we published the findings of our research on maternal mental health. This was based on the experiences of 1,738 women who had a mental health condition diagnosed before, during, or after having a baby or experienced a mental health problem that was not diagnosed.
This work highlighted that many women are not getting maternal mental health support that meets national guidelines. A third said they did not receive any advice on mental health during pregnancy at all. A third described the support the mental health support they received during pregnancy as ‘very poor’.
Bringing patient views to decision-makers
In August 2020, we provided written evidence to a parliamentary select committee inquiry which examined evidence related to ongoing concerns in maternity services.
In May this year, we published a review of evidence on maternity services between April 2021 and March 2022, to contribute to the refresh of the NHS Long Term Plan.
Nearly half (47%) of the people we heard from in this period reported broadly negative experiences of maternity services. Our feedback has become more positive across all services, whilst the proportion of positive feedback on maternity services has decreased (21% in 2021/22 compared to 31% in 2019/20).
One particularly strong message was just how much patients were feeling the lack of staff, and this was compounded by partners not being allowed into hospitals during the pandemic to help provide additional support.
Wider themes included mothers frequently not experiencing continuity of care, overstretched services, fathers and partners being frequently overlooked, and a lack of mental health support throughout the perinatal period. There were also examples of maternity care where things had gone badly wrong, having a lasting impact on families.
Our work
Following our work in 2019, NHS England announced that from April 2020 all women in England who have a baby will have a six-week assessment of their wellbeing, to include a focus on identifying mental health issues. To fund the initiative, NHS England provided £12 million in funding to GPs, as part of a new five-year contract.
The NHS Long Term Plan published in 2019 also set out a focus on improving maternal and neonatal health, including reducing racial disparities in maternal health outcomes.
As our recent review of evidence on maternal mental health showed that feedback from patients to Healthwatch about maternity care is worsening, we are now conducting further research to understand if the changes we helped bring about are improving mental health support for new parents.
We are using a survey, qualitative interviews, and freedom of information requests to understand not only if GP check-ups are taking place, but whether they are meeting women’s needs and providing them with an opportunity to discuss their mental health and access support from specialist services. This work will be published in 2023.
