This survey looked at the experiences of women and other pregnant people who had a live birth in early 2023.
Women and other pregnant people who gave birth between 1 and 28 February 2023 (and January if a trust did not have a minimum of 300 eligible births in February) were invited to take part in the survey. Trusts with sample sizes meeting this minimum were asked to additionally sample ethnic minority groups from January and March to enable statistical analyses at regional and ICS levels. Fieldwork took place between April and August 2023. Responses were received from 25,515 women and people who had recently given birth. This was a response rate of 41%.
What we found
At a national level the 2023 maternity survey shows that people's experiences of care have deteriorated in the last 5 years. Trend analysis was carried out on 26 evaluative questions on data from between 2018 and 2023. Of these questions, 1 showed a statistically significant upward trend, 14 showed no change and 11 showed a statistically significant downward trend.
However, results relative to 2022 show signs of improvement in many areas. Of the 54 evaluative questions compared year on year, between 2023 and 2022, 38 showed significant improvement, including all questions in the area of antenatal care.
- Of the 13 evaluative questions in the antenatal care section for which we have 2022 data, all showed statistically significant improvements between 2022 and 2023.
- While results are poor in midwives ‘always’ aware of their medical history (54% in 2023), this is a significant improvement from 2022 (49%).
Mental health support
- Respondents reported better experiences of antenatal and postnatal mental health support than in 2022.
- Three quarters (75%) said their midwife ‘definitely’ asked about their mental health during antenatal care, compared to 71% in 2022. Mental health support during pregnancy has also improved with 88% of people reporting that they ‘definitely’ received support in 2023, compared to 85% in 2022.
- Nearly three-quarters of women and other pregnant people (71%) said their midwife definitely asked about their mental health during antenatal check-ups; an improvement compared with 69% in 2021 and 67% in 2019.
Key areas for improvement
Availability of staff
- When in hospital during labour and birth, 25% of people were left alone at some point during, or shortly after, the birth at a time when it worried them. Five-year trend analysis for this question shows a decline in experience since 2018.
- There was a decrease in the percentage of respondents reporting they were ‘always’ able to get a member of staff to help when they needed it when in hospital after the birth (55% in 2023 compared to 57% in 2022). In 2023, 10% said they were not able to get help.
- In addition, there has been a downward five-year trend since 2018 for women saying they saw or spoke to a midwife as much as they wanted after the birth, from 73% in 2018 to 63% in 2023.
Communications and interactions with staff
- Survey results showed a five-year downward trend for respondents saying they were ‘always’ given the information and explanations they needed whilst in hospital after the birth. This year’s results found 60% of respondents reporting that they ‘always’ received the information and explanations they needed, compared to 65% in 2018.
- While there is no statistically significant change between 2022 and 2023 in the percentage of people reporting they had the opportunity to ask questions about their labour and birth, one in four respondents (24%) were not given this opportunity.
How experience varies for different groups of people
Women and other pregnant people report some differences in their experiences of maternity care. Frequency of contact with the same midwife had an effect, with respondents who had the same midwife throughout antenatal care reporting more positive experiences in nearly every area. Those who had higher frequency of contact during postnatal care, reported better than average experiences for 16 out of 31 themes examined. Frequency of contact during antenatal and postnatal care, as well as continuity of midwife across antenatal and labour and birth also show a better than average experience of providers being aware of their medical history.
Women who had an unassisted vaginal delivery were also consistently more likely to report positive experiences. Women were less likely to report positive experiences across the maternity care pathway if they have had an emergency caesarean birth.
Respondents with pelvic floor problems reported worse experiences in being treated with kindness, understanding and compassion, as well as pain management. Worse experiences were reported in 26 out of 31 care areas, for those who had ‘another pregnancy-related health condition. In both cases, respondents were more likely to consider making a complaint.
Respondents who reported having a long-term mental health condition were more likely to report poorer experiences in their concerns being taken seriously during antenatal care, confidence and trust during antenatal care, listening during postnatal care, able to clearly understand communication, their personal circumstances being taken into consideration during postnatal care, their choices on feeding baby respected, and being treated with respect and dignity.
Results for NHS trusts
Each trust has been provided with a benchmark report, which provides: detail of the survey methodology, headline results, the trust score for each evaluative question, banding for how a trust score compares with other trusts and historical data (where available).
How will results be used?
We will use the results from the survey to build an understanding of the risk and quality of services and those who organise care across an area. Where survey findings provide evidence of a change to the level of risk or quality in a service, provider or system, we use the results alongside other sources of people’s experience data to inform targeted assessment activities.
Trusts, and those who commission services, use the results to identify and make the changes they need to improve the experience of people who use their services.
NHS England and NHS Improvement; and the Department for Health and Social Care
Information collected nationally in a consistent way is essential to support public and Parliamentary accountability. The results are used by NHS England and the Department of Health and Social Care for performance assessment, improvement and regulatory purposes.