Wednesday, 11 October 2017

You have a choice #YourBirthPlan


Giving birth is an intense and life changing experience. We all have a choice with the decisions we make when it comes to giving birth however, detailed guidance can be difficult to find. The Care Quality Commission’s new campaign #YourBirthPlan promotes the message that all women and prospective parents should know where to access the information that can help them make informed decisions personal to them.

With a background in public health, I researched my birthing options as much as I possibly could with the information available to me at the time but found the guidance given to me differed between regions. I moved from Cambridge to Brighton during my pregnancy and must say in Cambridge appointments were often rushed and staff unfriendly. In Cambridge, I never saw the same midwife twice and one midwife was so rude and dismissive that I made an official complaint! During one appointment, I waited two hours for the midwife to arrive at the surgery and didn’t even receive an apology. After I moved to Brighton most of my appointments were with the same midwife until I gave birth. Appointments were timely, midwives answered all the questions I had and the staff were so much friendlier. These things made a huge difference to my personal experience and overall pregnancy.


My birth at the local hospital was a slightly different story. Although my birth was relatively straight-forward there were some complications. I was hooked up to a monitor during labour because Pip’s heartrate was dipping. Staff were in and out of the room monitoring me but no-one explained the implications of his heart rate decelerations or how it may have affected the birth. As a result, I was left worried and confused, wondering if my baby was OK or not. There was some panic and a sense of urgency surrounding the actual delivery but when Pip was born he was absolutely fine! At that time, I was relived I had a beautiful & healthy baby boy but later I had many unanswered questions. The post-natal ward was busy, noisy and understaffed and for several reasons I couldn’t wait to get out of there. Thankfully in Brighton there is a service called Birth Stories, a wonderful informative service where an experienced midwife will go through your birth notes and answer all the questions that were not answered at the time of birth. It was incredibly helpful in understanding my birth and my options in the future. However, the popularity of Birth Stories shows how many mothers have unanswered questions. Surely, adequate information should be provided at the time of birth. If I were to give birth again I am not sure I would choose the same hospital.

The Care Quality Commission (CQC) has recently released new research findings that show women must be made aware of their right to choose their birth location. The CQC interviewed over 1000 women who had given birth in the last three years. Although 90% of women said it was important to choose the birth that they wanted and make a birth plan, 40% of women surveyed either weren't aware or felt they did not have a choice over their birth hospital. Furthermore, 57% of women spent less than an hour choosing their birth hospital, perhaps indicating a lack of awareness about the information available on all possible choices. The CQC findings show that 65% of women wanted a birth in a hospital close to their home, 55% wanted a clean and safe hospital, 39% wanted a hospital with a good reputation and 36% wanted a location with caring staff.



Of course, during any birth there are many things that don’t go to plan and you need to keep an open mind. For example, I would have loved a water birth but it wasn’t possible because of Pip’s dipping heart rate. However, there are many things you do have a choice over. Ask questions, read research studies, find out as much information as possible. If you’re not happy or something doesn’t feel right question it. The CQC provides detailed inspection reports on health services across the country and 95% of those surveyed found them useful. Each inspection gives a detailed rating of specific services within any health provided including Maternity & Gynaecology and answers five key questions: Is the service safe? Is it effective? Are the staff caring and responsive to people’s needs and is the service well led? Interesting, at the time I gave birth the CQC rated the Maternity and Gynaecology at my local hospital as ‘requiring improvement.' Its recent inspection report from August 2017 shows is it now rated as ‘Good’ so I’m glad to see that local services are improving. The report details where improvements have been made and what still needs to be done.

Are you pregnant or thinking about giving birth soon? If so, more information about the CQC campaign is on their Making Your Birth Plan page with tips on choosing maternity care, experiences from women who have recently accessed maternity care services and how to find reports about your local maternity services. You have a choice so make the right decisions for you!

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Were you happy with the choices you made in your birth? What could have been improved? Have you read the CQC inspection reports? I’d love to hear your views.

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3 comments

  1. It is so sad, frustrating, and disappointing that a lot of doctors and midwives make you feel like you don't have a choice. Pretty much all of them told me I wasn't having a c-section even though I had legit reasons to have one and even had a doctor's note of recommendation from one of my specialists and they even tried talking me out of it a thousand times when I was in active labor. I'm so happy I refused to let them force me into a vaginal delivery especially since at 2 CM dilated, Rory had already passed meconium inside of me. If they made me wait until I was 10 cm and deliver vaginally, she very well could have swallowed meconium and died. I had my intake appointment for this pregnancy last week and said right off the bat that I want a repeat c-section and my tubes tied. I think saying I want my tubes tied help them just be like "ok, fine" b/c then they can just do that procedure while they have me cut open.

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  2. These are quite surprising statistics. I didn't get the birth I'd planned or hoped for with either of my two children but they were born healthy and that's all I could ask for x

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  3. It's so true hat things don't always go to plan. My first labour certainly didn't but experience and thinking things through properly helped so much the second time around

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