Healthwatch Camden calls for greater improvements in local maternity services

  • Women with language barriers and BAME women most affected by lack of quality maternity services.
  • Report revealed insight into the experiences of giving birth in UCLH and the Royal Free Hospitals, as well as what it’s like to work there.
  • Many women had little to no idea what a birth plan was, even after giving birth
  • One woman recalled her consultant “reading the instructions” on how to give her a procedure
  • COVID restrictions shone a light on accessibility for patients, but vast improvements still needed

Healthwatch Camden has released a report called ‘Birth Stories: Experiences of Maternity Services in Camden’. The report gathered insight from local women and their experiences of using NHS maternity services in Camden’s two hospitals, UCLH and the Royal Free London.

The report revealed that many local women, especially those with language barriers and many BAME women, were more likely to have a negative experience using local NHS maternity services.  It also revealed some levels of unprofessionalism within the services.

Communication issues

Communication and language barriers were very significant in affecting the experiences of women using local maternity services.

Whilst there were translation services across the wards, many women revealed that they found it difficult to have their medical concerns heard by professionals. One mother described her experience when one of her babies had jaundice:

“I kept asking for somebody to look at him and none of the midwives would look at him”.

One woman revealed that she didn’t feel listened to unless her partner was in the room:

“I went alone and it was not a nice experience. It was literally two minutes in and out. So, the second time I made sure that I brought him. He came to all the milestone scans”.

Feeling unprepared

Many women described how they felt unprepared going into labour. UCLH and the Royal Free issue birth plans for expectant mothers, recording what they’d like to happen during labour and after giving birth. However, many women weren’t aware of a plan at all.

One woman, who was to give birth to twins, was told that the birth plan preparation would start two weeks after she actually gave birth.

Several women revealed experiences where the staff seemed very unready to meet their health needs. One woman described how her consultant was “reading the instructions” on how to give her a procedure. Her midwife took over and was able to complete the procedure in a few minutes. She recalled the experience as being

“like heaven and hell”.

Impact on BAME women

Many respondents in Healthwatch’s report were from BAME backgrounds, reflecting the racial and ethnic diversity of Camden. These women were found to have a higher chance of a negative experience using the services, with some of those experiences being directly related to their race. One woman recounted a nurse telling her

“you should be stronger because you’re African”.

This report follows wider national reports, which reveal that Black women are four times more likely to die during childbirth, and on the whole BAME women face poorer experiences across maternity care services compared to white women.

The report also revealed that some wards in Camden do not have mandatory training for addressing the needs of BAME women throughout their pregnancies, and confronting the data on health inequality.

The impact on midwives

Maternity wards in Camden are also under a severe amount of stress.. In interviews with midwives from Camden’s two hospitals, the report revealed that staffing issues is a leading factor in low staff morale. Midwives added that although their hospitals have well-being support, many are unable to attend or have time to ‘wind down’ because of widespread staffing issues.

Many women were sympathetic to the stresses of working in the NHS, but also felt let down by professionals. One woman, who had an emergency C-section, was told to “ring the bell when [she] needed help” but added:

“Either someone wouldn’t come or when they came, they said they can’t help me”.

Because of staff shortages, many midwives are not able to stay with one woman throughout her pregnancy, which was found to negatively impact many of the women’s experiences using the services.

The report revealed some positive changes to local maternity services, many of them impacted by COVID. There is greater flexibility in at-home or in-person appointments, which is “more accessible for women and actually reduces some pressure on the service”, as suggested by one midwife.

Healthwatch Camden are making a series of recommendations, including improving methods to provide more continuity of care, improved training on race and ethnicity, and more substantial well-being systems for midwives to cope with stress and staffing issues.

Stephen Heard, Director of Healthwatch Camden said:

“For many expectant parents, the pregnancy is a time for large amounts of uncertainty.  The foundation of a positive experience is effective communication and confidence that they will be looked after throughout their time during pregnancy and birth. This should be valued consistently alongside the setting of expectations that if things change during their pregnancy or birth that they will be looked after.”

“We recognise the stress local maternity wards are under and are grateful to the midwives who spoke with us. The wellbeing of maternity and hospital teams should be a focus to ensure they can give consistent, appropriate, and compassionate care for all maternity patients.”

The report can be found here.