Maternity care “fell short of expectations,” regulator’s annual survey finds

Women’s experiences of maternity care in England have deteriorated in several key aspects over the past five years, raising alarm bells for the NHS, experts have said following publication of the health regulator’s annual national maternity survey.1

For the survey the Care Quality Commission (CQC) asked nearly 19 000 pregnant women and new mothers who used NHS maternity services in 2024 about the care they received while pregnant, in hospital during and after labour, and at home.

It found signs of better access to mental health support in the past year. More women were asked about their mental health during antenatal checkups compared with last year, and this area has seen steady improvement over the past five years.

But many women reported a poorer experience for other aspects of maternity care.

It was “disappointing” that for some women the care they received “fell short of expectations” while trust in staff has fallen, said Nicola Wise, CQC’s director of secondary and specialist care. “Looking back at the results from the past five years there has been decline in those able to get enough help and support during labour and birth, in access to pain relief while in labour, and the availability of information and support after giving birth and during subsequent postnatal appointments,” she said.

The CQC said subgroup analysis of this year’s survey results show that women who reported their ethnicity as Indian, Pakistani, and “any other white background” reported poorer experiences, including not feeling listened to and not receiving help during their antenatal and postnatal care.

Sandy Lewis, programme director of the Maternity and Newborn Safety Investigation Programme, acknowledged that there were positive reflections in the survey but said “the long term decline in positive feedback across maternity services over the past five years should raise alarm bells.”

Of the respondents 14% said that staff did not do everything they could to help manage pain during labour and birth. A quarter (25%) said they felt they did not have the opportunity to ask questions after their baby was born, and only 58% said that they were always given the information and explanations needed (compared with 60% in 2023).

There has also been a five year downward trend in the number of women reporting that they were always able to get help from staff during labour and birth (64% in 2024) and in those who said they were always spoken to by staff in a way they could understand (85% in 2024). 

Just over half (60%) of those surveyed said they saw or spoke to a midwife as much as they wanted after the birth (down from 63% in 2023). And fewer reported always feeling listened to by staff providing postnatal care after leaving hospital (75% in 2024 compared with 77% in 2023).

Wise said that NHS trusts should reflect on the survey findings to deliver better experiences of maternity care.

“Increased national action and additional capital investment to support staff to deliver the high quality care they want to provide for mothers and babies every time should be a priority,” she said.

Chief midwifery officer for England Kate Brintworth said mental health support was vital during pregnancy and signs of improved access during pregnancy was “encouraging.”

“But we know there is much more to do to ensure all women and babies receive high quality personalised care,” she said.