We were really pleased to welcome everyone to our Maternity and Neonatal Partnership meeting on 7th December at Hilltop Children’s Centre, Cinderford.

We had 12 service users attend, along with some babies and toddlers. 6 representatives from community groups and 15 health professionals, including midwives and health visitors, also attended. In total we had 33 adults. The purpose of these events is to bring everyone together, discuss the current situation within maternity care, listen to feedback about women and birthing people’s experiences and co-produce ideas and solutions. You can read about what was discussed below.

We’d like to thank everyone who attended, shared their experience, and took part in the discussions.

Presentations

We had two presentations at the event, one from neonatal care and an update from maternity.

Neonatal

Catherine from the Neonatal Team talked about a survey they have conducted. The survey was co-produced with parents who had experienced neonatal care. It has been a huge undertaking and the team now have all the data back, so that they can create an action plan.
The presentation was well received, there were some questions about ensuring that the voices of all communities are heard. There is ongoing work to ensure that seldom heard voices are captured and supported to be part of projects.

Maternity – Scans

Susan, the Consultant Midwife, gave an update on maternity services in the Forest of Dean. When the new hospital is built and open, they will offer dating scans, nuchal scans and anomaly scans. This will be on Thursdays.
This news was very well received, as families have been telling us that they want more local services. Gloucester is not always accessible to everyone in the far reaches of the county, due to public transport limitation, travel and parking costs and time.

Questions about scans

  • Can this be audited to see if the service needs more days and is meeting the need, when it is established?
  • Could there be a consultant on site to discuss results with after?
  • Is there a possibility to have growth scans at the new hospital?
  • Could services within the hospital be extended to offer glucose monitoring within the Forest of Dean?

Focus groups

We had three focus groups at this event. Attendees were able to choose which focus group they joined.

Focus Group – Antenatal Education

There is work going on across the county to improve antenatal education. We wanted to hear experience of antenatal care and antenatal education.

There is a potential to invest in an electronic program, The Real Birth Company (RBC), which would have various sections and information for women and birthing people and their partners, to work through at their own pace. This would be accessible in several languages. Alongside this we would want to still offer face-to-face support and were interested to know what people would want.

Discussion

What do you want from an antenatal class?

  • To network with other mums, often pregnant women do not know their local communities.
  • Interactive classes.
  • The group felt that the knowledge women had before classes was not always good, often based on family or friends’ experience, professional input needed.
  • A way of getting to know what support is available e.g., breastfeeding
  • Sessions should include information about neonatal and perinatal experiences, which may include a baby in NNU, post-natal depression etc. Ensure that women are not scared but they need to know about what happens when things don’t go quite so well.
  • Video tours of Neonatal Unit are positive.
  • Suggestion to add more local films and information e.g., a caesarean birth, what happens in theatre.
  • Important that there is human interaction as well as online content.
  • Discussed use of tools such as Real Birth Company. It is positive that content can be revisited and worked through at your own pace.
  • Discussions about classes being a collaboration of service providers; there is a role for community groups e.g., breastfeeding support groups and Home Start, in supporting a course.
  • Importance of the role of the clinician in ensuring women are able to navigate systems and are supported to make decisions.
  • Important that classes make women feel more confident to ask questions about their care e.g., when making decisions such as being induced.
  • Suggestion for an early antenatal session around 20 weeks.
  • Suggestion for Postnatal group.
  • Suggestion for WhatsApp groups.

What would stop you going to a class?

  • Don’t want to be talked at
  • Accessibility.
  • Not knowing they can have time off work.
  • Discussed time of day but no clear consensus, the suggestion was to offer a variety of times.

Positive feedback from Forest antenatal groups

  • Held in Children’s Centre; get support with setting up room etc, women get to know about baby groups.
  • Health visitors attend classes with the midwife.
  • HomeStart and breastfeeding support groups attend some sessions to introduce themselves.

This focus group was made up of stakeholders such as HomeStart, breast feeding supporters, perinatal mental health support, rather than service users.

We discussed possible names or titles for antenatal education:

  • Something with ‘Journey’.
  • Birth With Confidence.

Actions

  • MNVP to ask on social media for suggestions of what the service should be called.
  • Kay Davis is going to use this discussion to help inform the work of setting up an antenatal offer in Gloucestershire.

Focus Group – Tours of the Units

We have heard from women, birthing people and their families that they want to be able to visit the birth units and delivery suite and have a tour prior to birth. The tours in Gloucester have not been able to happen for some time. Stroud is now offering tours again and Cheltenham is awaiting reopening. If tours at Gloucester do start again, we would be interested to know what women, birthing people and their partners want from them.

  • How important is a face-to-face tour to you, compared to a virtual tour?
  • What would you expect from a tour of a birthing unit?
  • When should these tours take place during the day?
  • Who would you prefer to show you around? Does it need to be a midwife or a maternity care assistant? Could it be someone who is not clinical?

Discussion

  • Concerns were expressed about when to do tours and making sure that the units are not overloaded.
  • 1:1 tours can happen for those who are very anxious.
  • A virtual tour could be created, which starts at the car park and does a full walk through to the units.
  • Any set times for tours can be a barrier for women, birthing people and partners to attend.
  • Comment from another group – tours do not need to cover clinical areas. Appreciate the opportunity of a trial run, working out where to park etc.

Actions

  • Consider creating a virtual tour, these could be more accessible, translatable and be able to have British Sign Language version.
  • The MNVP to look at how we can get service user feedback on this topic. There were no service users in the focus group for this topic.

Focus Group – Experiences of Maternity Triage

The MNVP has heard that attending triage can be difficult for some people. This may be due to location, distance, cost to get there, childcare concerns. We have also heard that some people do not want to attend with reduced movements in case this puts them onto a consultant led pathway. We wanted to understand experiences of triage, as a service user, midwife, or community representative. We will feed back all comments to triage.

The following are quotes from our survey about triage:

“When we saw the registrar, we found his manner to be quite rude. I asked why he was offering me an induction at 40+6 (I was in triage for reduced movement concerns) when I had been under the impression from my community midwife that I wouldn’t be offered induction until I was 12 days past my due date. His response was “well you’re obviously here because you’re worried about reduced movement, and it’s annoying for us as movement is subjective, so we just want to get it going for women who are term”

“’If you have bloods, MSU or swabs taken you don’t always hear back for the results.”

“Every member of the team I met with were kind, compassionate and took the time to listen to myself and my husband, explain everything step by step and provide informed choice.”

“None of my concerns were listened too. She was dismissive of what I was trying to say. The reason being that I turned up to triage after ringing with no answer on the phone and that was a more important issue to the midwife than the worries I had for my baby.”

“It was not fully explained to me what the possible causes of reduced movements were, what the process with CTG monitoring would be.”

“Comfier chairs in waiting room needed.”

“Felt like I’d made the right decision coming in and that I was well cared for and listened to.”

  • What is your expectation from triage, in terms of when you turn up and what you can go to triage for?
  • What is your experience of the waiting area?
  • What is your experience as a service user?
  • What is your experience as a midwife or community representative?
  • Have you used triage since the new BSTOS system was put in place? Do you understand it?

Discussion

  • The gap between the 16 week appointment 24 weeks feels very big – Families were unsure what the early pregnancy unit offer and when they can be seen by triage.
  • It can be hard living in the Forest of Dean and presenting at triage, there are cost and time implications.
  • Someone shared that they felt their age was a factor in receiving care at triage, they felt judged for being a young mum.

Actions

  • Triage is often full and can be overwhelming. Some ideas for improvements
    • Bigger posters.
    • TV with rolling health information.
    • Space dividers.
    • A journey map to show what will happen when presenting at triage.

Consider how to show which teams deliver what care, and at which stages of pregnancy.

Ideas for next focus groups

  • Experience on the postnatal ward
  • IVF support – gaps in pathways
  • Care after birth
  • Staffing – Solutions and staff attitudes
  • Tongue tie

Next steps

Attending future meetings

If you are a current or recent user of maternity services in Gloucestershire, a health professional, or otherwise interested in local maternity services, we would welcome you along to future meetings. Please take a moment to fill in our membership form, and we will ensure you are sent details once they are confirmed.

Our next Maternity and Neonatal Partnership Meeting will take place in March 2024. Find out more and book your place here.

Giving feedback

If you do not wish to become a member but would like to give feedback about your maternity experience, you can do this in one of two ways: