Bromley Maternity Voices Report

Key Findings:

Antenatal Care

• Referral pathways are effective, with appointments secured promptly.

• Clinics and scans are well organised, with appointments running to time.

• Doctors and midwives are responsive and supportive, on the whole.

Birth/Labour

• Midwives and doctors are supportive, responsive & reassuring, on the whole.

• Good levels of user involvement are reported – with care plans respected.

• Partners are supported and included.

Postnatal Care

• Support for breast feeding is good, however alternatives are not addressed.

• The majority of people feel informed at discharge.

• Midwives and health visitors are helpful and approachable, on the whole.

Recommendations

Antenatal Care

• Many people do not have a named or regular midwife, with the lack of continuity making it difficult to build personal relationships.

Suggestion: While there are constraints on staffing, continuity is important for some people. If registration forms contained a ‘how important is it to see a named midwife’ question, it may be possible to target consistency where most needed.

• The clinic can be a long distance from home or work, with implications on travel time and cost. Choice is also limited.

Suggestion: We know that some residents already use out of borough services that are closer to home (such as in Shirley). Choice should be offered wherever possible, with distance and bordering services considerations on referral.

Birth/Labour

• People arriving too soon to be admitted can be sent home without adequate information or reassurance, adding to anxiety and stress.

Suggestion: With accounts of births happening at home, and ‘near misses’ as a result of being turned away, people are right to feel anxious. Perhaps giving the option to remain somewhere closer, such as the hospital canteen is a safer option for some. Nobody should be sent home without adequate advice, support and reassurance.

• Transition between midwife shifts is not always well co-ordinated, leading to conflicting information and confusion.

Suggestion: In the cases identified, staffing levels and pressures are cited as a possible cause. If possible, support midwives to spend more time on transition between shifts.

Postnatal Care

• Health visitors can be ‘too focused’ on breast feeding, with insufficient advice or support on alternatives.

Suggestion: If midwives or health visitors are unable to provide support on areas such as CMPA, signposting advice would be beneficial, and reduce anxiety and stress.

• Many people say the number of visits is not sufficient, with some expressing frustration and disappointment.

Suggestion: We know that service level must reflect the level of need. If the standard number of visits is made clear from the outset, this would reduce disappointment and encourage people to make the best use of the time, knowing it is limited.