Maternity study shows room for improvement in care after birth

The study, published by Hiqa, shows most people had positive experiences of maternity care, but some felt that care in the period after birth needed to improve. Picture: Sasko Lazarov/Photocall Ireland

One-in-10 women say they were not involved in decisions about their care during labour and birth, according to a new in-depth study on maternity in Ireland.

The study, from the Health Information and Quality Authority (Hiqa), shows that 85% of women had a good experience of maternity care in Ireland, but some women reported that care in the period after birth needed to improve.

One respondent said current care structures makes "it feel like you are unimportant once the baby is no longer in utero", while another respondent said aftercare at home was "very poor".

"Was barely contacted for first few weeks by public health nurse after having a section," said another.

Some women said they did not receive sufficient physical and emotional support during and after labour because hospital staff were very busy.

One respondent said: 

Early labour - felt very alone and unsupported. But in fairness, the nurses were very busy. I wasn’t really checked on.

Another respondent said first time mothers should be treated with extra care.

"Should be more discussion about pain relief options during labour. For first-time mother should be extra care with their worries. At the hospital (during and after labour) should be more help to reduce stress."

Reacting to reports that midwives were busy, the INMO said the report is further evidence that the sector is understaffed.

General Secretary Phil Ní Sheaghda said "There is still no funded plan to get the midwifery workforce to safe and appropriate levels. Women clearly deserve better: the current medically focused model can rush women through, leaving many without the aftercare they need.

Almost one-quarter of respondents said that they were left alone at some point by healthcare professionals at a time that worried them, and this mainly occurred during early labour, while almost one-third (32%) of women said they did not receive sufficient information about changes to their mental health during pregnancy.

The findings came from Hiqa's National Maternity Experience Survey. The results were mainly positive, with some areas needing improvement.

The average rating for the 'care while pregnant' stage was 7.4 out of 10, while 'care during labour and birth' was rated 8.6 out of 10.

However, 10% of women said that they were not involved in decisions about their care during labour and birth.

The average rating for the 'care in hospital after the birth' stage was 7.5 out of 10.

Women who had previously given birth were more likely to have a positive experience, and women who had home births reported more positive experiences than women who gave birth in a maternity unit or hospital.

Some 30% of women said they had no 'debriefing', meaning they did not get to ask questions about the labour and birth after their baby was born.

In terms of neonatal care, 90% of women said the care their baby received in the neonatal unit was good or very good.

However, 24% said that they did not receive enough emotional support from healthcare professionals while their baby was in the neonatal unit, mainly due to staff shortages.

The busiest maternity hospital in the country, The Rotunda, has welcomed the findings. The Master of the facility Professor Fergal Malone said "We intend to further improve our services in light of the results of the National Maternity Experience Survey, in particular by focussing on better communication with patients, improving access to information, driving improvements in our physical infrastructure, and maximising our staffing with midwives, breastfeeding support and mental health support." 

"We have outlined a range of specific interventions and new programme development to further improve the service experience at the Rotunda.”