What the 2017 Maternity Survey tells us about women’s experience of emotional support
The 2017 Maternity Survey – part of the NHS Patient Survey Programme – received feedback from over 18,000 women who had given birth in January or February 2017 across 130 NHS trusts in England.
Pregnancy, giving birth, and the postnatal period can all be stressful and emotional times for women, which can impact negatively on not only women themselves, but their babies and families (The Royal College of Midwives, 2012). Therefore, a key part of providing high-quality maternity care is making sure women are supported emotionally at all stages of their maternity pathway. In this comment piece we will be exploring what the 2017 Maternity Survey results have to say about women’s experiences of the emotional support provided by NHS trusts. We will be relating the findings to three of the eight Picker Principles of Patient Centred Care.
Developed through empirical research, the Picker Principles provide a framework for supporting the delivery of high-quality, person-centred care for all. As a charity, Picker is dedicated to promoting the Picker Principles in all aspects of healthcare. We measure patient experiences of health services to identify whether the Picker Principles are being delivered and where improvements can be made.
Clear, comprehensible information and support for self-care
The first Picker Principle we will be focussing on involves the provision of clear and comprehensible information. One of the positive findings from the survey was that the percentage of women who were ‘definitely’ given enough information about emotional changes they might experience after giving birth has increased from 57% in 2015 to 59% in 2017. However, there is evidently still work to be done as almost one-third of women (29%) were only given this information ‘to some extent’, and 12% were not given enough information at all. These shortfalls suggest that NHS trusts may not be delivering against the Picker Principle of information provision, meaning that some women with mental health needs may be falling through the net.
Emotional support, empathy and respect
The next Picker Principle we wish to highlight involves emotional support. Two-thirds of women (64%) were ‘definitely’ asked how they were feeling emotionally during their antenatal check-ups. Encouragingly, this was up by 7% since 2015, the largest positive change between 2015 and 2017 out of all survey questions, suggesting that the Picker Principle relating to emotional support has been a key focus for NHS trusts since the 2015 survey. Another positive is that nearly all women (98%) were asked how they were feeling emotionally during their postnatal appointments with a midwife or health visitor. However, there is still room for improvement as one in ten women (10%) were not asked how they were feeling emotionally during antenatal check-ups, and one in four (26%) were only asked ‘to some extent’. Identifying potential mental health needs as early on in the woman’s care as possible is critical to ensuring high-quality care throughout her pathway.
Fast access to reliable healthcare advice
The final area we will be focusing on is women’s access to emotional support postnatally, which relates to the Picker Principle of ‘Fast access to reliable healthcare advice’. While the vast majority of women (96%) were provided with a telephone number for a midwife or midwifery team they could contact while at home after the birth, access to emotional support specifically was less widespread. One in five women (22%) were not told who they could contact if they needed advice about emotional changes they might experience after giving birth. It is worrying that some women are not able to access the support they need after giving birth, especially considering that this challenging period of transition can have a significant impact on women’s wellbeing (The Royal College of Midwives, 2012).
In summary, results from the 2017 Maternity Survey indicate that NHS trusts in England are making much-needed progress in certain aspects of emotional support, including providing women with information about emotional changes and asking about their emotional wellbeing. We are pleased by these results as they indicate that NHS trusts are taking action to make improvements in areas relating to the Picker Principles of information provision and emotional support. However, there are still several concerning results suggesting that further resourcing and investment is needed, particularly in making sure that women have adequate emotional support after having their baby.
Results from the next Maternity Survey (2018) will help us to monitor developments in this critical area of maternity care, and as such to ensure the Picker Principle of ‘Fast access to reliable healthcare advice’ is being delivered to women using maternity services across England.
The National Maternity Review (2016), Better Births – Improving outcomes of maternity services in England: A Five Year Forward View for maternity care, https://www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf
The Royal College of Midwives (2012), Maternal emotional wellbeing and infant development: A good practice guide for midwives, https://www.rcm.org.uk/sites/default/files/Emotional%20Wellbeing_Guide_WEB_0.pdf