A Prepaid Envelope Was Enclosed to Facilitate Return of the Completed Forms

Introduction

This survey was undertaken to elicit the views of service users on the intrapartum and postnatal services provided by Weston Area Health Trust (WAHT).

The survey questions used are based on the CQC Maternity Survey 2013 (CQC 2013), section C (Labour and Birth, and section D (Postnatal Care). Due to the small number of births the Trust is not included in the national CQC survey.

Method

Fifty women giving birth on the Ashcombe Birth Centre, or having a home birth attended by midwives employed by WAHT, were sent survey forms (appendix 1) with a covering letter. The questionnaire and letter had been checked and agreed by the Associate Director of Governance & Patient Experience.

A prepaid envelope was enclosed to facilitate return of the completed forms.

The sample of women were the 50 most recent births taken from the birth register prior to the end of August 2014.

The women were asked to rate answers questions on a Likertscale of 1 to 10, where 1 is the worst score, and 10 is the best.

On receipt of the completed forms the data was entered onto a spreadsheet to aid analysis.

Results

Eighteen women returned completed survey forms giving a response rate of 36%.

Of the 18 women:

17 received Intrapartum care on ABC (94.4%)
1 was an unplanned home birth (5.6%) This woman came to ABC for postnatal care after the birth.
15 received postnatal care on ABC (83.3%)
3 were transferred to St Michael’s Hospital for postnatal care due to complications e.g. perineal trauma not suitable for suturing by a midwife (16.7%)
One additional woman was transferred to St Michael’s for suturing but provided responses to the postnatal questions. It is not clear whether she returned to ABC for postnatal care after suturing was completed, or whether her answers refer to the care at St Michael’s Hospital.

Labour and birth

Qn 1. At the start of your labour, did you feel that you were given support when you contacted a midwife?

17 women responded to this question
The woman who did not respond wrote ‘not applicable’ on the form. She had been due to go to North Bristol NHS Trust in labour but was redirected to ABC due to the labour ward being closed. Her comment is comment number 8 below.
11 women gave a score of 10
4 women gave a score of 9
1 woman gave a score of 8
1woman gave a score of 6
The woman who gave a score of 6 did not comment on this question

Qn 2. During your labour, were you able to move around and choose the position that made you most comfortable?

17 women responded to this question
The woman who did not respond wrote ‘NA’ on her form. She was an unplanned home birth.
15women gave a score of 10
2 women gave a score of 9

Qn 3. If your partner or someone else close to you was involved in your care during labour and birth, were they able to be involved as much as they wanted?

16 women responded to this question
Of the 2 women who did not respond
One wrote ‘NA’ on her form. She was an unplanned home birth.
One wrote ‘not sure’ on her form. She did not comment specifically on this question.
14 women gave a score of 10
2 women gave a score of 9

Qn 4. Did you have skin to skin contact (baby naked on your chest or tummy) with your baby shortly after the birth?

18 women responded to this question
17 women gave a score of 10
1 woman gave a score of 4
The woman who gave a score of 4 wrote, ‘Due to heavy blood loss not for 1st hour. I was being sick and the midwives needed to sort me out.’

Qn 5.Did the staff caring for you in labour introduce themselves?

18 women responded to this question
16 women gave a score of 10
2 women gave a score of 9

Qn 6. Were you left alone by midwives at a time when it worried you?

17 women responded to this question
The woman who did not respond wrote ‘NA’ on her form. She was an unplanned home birth.
13 women gave a score of 10
1 woman gave a score of 9
2 women gave a score of 7
1 woman gave a score of 1
The woman who gave a score of 1 did not comment on why she had given this score. Her comment is comment number 2 below.

Qn 7. If you raised a concern during labour and birth, did you feel that it was taken seriously?

16 women responded to this question
Of the 2 women who did not respond
One wrote ‘NA’ on her form. She was an unplanned home birth.
One commented on her form that she did not raise any concerns.
11 women gave a score of 10
4 women gave a score of 9
1 woman gave a score of 7

Qn 8. Thinking about your care during labour and birth, were you spoken to in a way you could understand?

17 women responded to this question
The woman who did not respond wrote ‘NA’ on her form. She was an unplanned home birth.
16 women gave a score of 10
1 women gave a score of 9

Qn 9. If you used the call button how long did it usually take before you got the help you needed?

10 women responded to this question
The remaining 8 women indicated that they had not used the call button. One was an unplanned home birth.
5 women gave a score of 10
2 women gave a score of 9
1 woman gave a score of 8
2 women gave a score of 6

Qn 10. Thinking about your care during labour and birth, were you involved enough in decisions about your care?

17 women responded to this question
The woman who did not respond wrote ‘NA’ on her form. She was an unplanned home birth.
12 women gave a score of 10
2 women gave a score of 9
1 woman gave a score of 8
1 woman gave a score of 7
1 woman gave a score of 6
The woman who gave a score of 6 commented, ‘I was concerned about the lack of fetal monitoring in the department. I would prefer to have been on monitoring during my labour.’

Qn 11. Thinking about your care during labour and birth, were you treated with respect and dignity?

18 women responded to this question
18 women gave a score of 10

Qn 12. Did you have confidence in the staff caring for you during your labour and birth?

17 women responded to this question
The woman who did not respond wrote ‘NA’ on her form. She was an unplanned home birth.
13 women gave a score of 10
3 women gave a score of 9
1 woman gave a score of 8

Care in hospital after the birth

Qn 1. Looking back, do you feel that the length of your stay in hospital was about right?

15 women responded to this question
The three women who did not respond were all transferred to St Michael’s Hospital after the birth due to complications
9 women gave a score of 10
4 women gave a score of 9
1 woman gave a score of 8
1 woman gave a score of 6
The woman who scored 6 commented that she had been required to be transferred to St Michael’s Hospital for stitches. Her comment is number 12 below.

Qn 2. Thinking about the care you received in hospital after the birth of your baby, were you given the information you needed?

15 women responded to this question

TThe three women who did not respond were all transferred to St Michael’s Hospital after the birth due to complications

13 women gave a score of 10
2 women gave a score of 9

Qn 3. Thinking about your stay in hospital, how clean was the environment you were in?

15 women responded to this question
The three women who did not respond were all transferred to St Michael’s Hospital after the birth due to complications
11 women gave a score of 10
2 women gave a score of 9
2 women gave a score of 8

Qn 4. Thinking about the care you received in hospital after the birth of you baby, were you treated with kindness and understanding?

15 women responded to this question
The three women who did not respond were all transferred to St Michael’s Hospital after the birth due to complications
11 women gave a score of 10
3 women gave a score of 9
1 woman gave a score of 5
The woman who gave a score of 5 was transferred to St Michael’s Hospital for stitches. It is not clear whether she came back to ABC for postnatal care. She commented, ‘Baby sent to St Michael’s with dad in car rather than in ambulance with me. Staff were kind but could have put baby at risk.’

Her comment is comment number 12 below. This is the same women who gave a score of 6 for Qn 1 (length of stay).

Qn 5. Thinking about your stay in hospital, how clean were the toilets and bathrooms you used?

14 women responded to this question
Of the 4 women who did not respond
3 were transferred to St Michael’s Hospital after the birth due to complications
1 indicated NA on her form
10 woman gave a score of 10
2 women gave a score of 9
1 woman gave a score of 6
1 woman gave a score of 5
The woman who scored 5 commented that, ‘Bins were full of the person’s before maternity pads and nappies (private room).’

Comments provided in the comments section:

The experience of labour was excellent under the circumstances. I couldn't have asked for anything better. The pool was amazing and aromatherapy oils were very helpful.
My birth experience at the birthing centre was very positive, much better than my first birth in a difficult hospital. The midwives at ABC were brilliant right from the first phone call through to after the baby was born. The only negative was the constant weighing in the baby's first week (which was unnecessary and unfair when trying to breastfeed) as I have since found out breastfed babies should not be weighed daily. The birthing centre was a pleasant environment to give birth in; it was lovely that my husband could sleep on the pull out bed after the baby was born. I was also pleased that the midwives followed my birth plan, not intervening until it was necessary and they were very respectful and kind. Overall a very positive experience only spoilt by the frequent, unnecessary weigh-ins.
I have always recommended Ashcombe Birth Centre and after delivering my 2nd baby now at Ashcombe I will continue. There was no rush for me to go home after giving birth and midwives were always around whenever I needed them. A calm, friendly environment.
I felt I was given a lot of care. Everyone (staff) was very happy and friendly. I had a student working with the midwife and I was introduced to her and she always went through what was going to happen and asked if it was ok with me. The midwife also kept telling me what was happening and checking if I was ok with it. Near theend of my labour I started getting upset (was on gas and air) and kept saying "I don't think I can do this" - they always reassured me and were positive. I wanted my husband to have first hold so he was offered skin-to-skin contact which he did. I then had skin-to-skin later that day. the only think I can say that I would have liked is for the evening visits from others, other than partner, is to be just a little longer by 1/2 hour or 1 hour as hard to fit visits in by that time. I had both my children at Weston and both times been very happy with my care during and after. If I ever have another I'd chose Weston - my sister is due this month and is going to Weston after hearing such good things.
Extremely happy with the help and kindness of all staff. Only wish Weston could have the facility like St Michael's and Southmead if any complications arise. Also to have a Doctor on ward to prescribe extra pain relief as did take a while if needed anything stronger than paracetamol.
During both my labours and births at ABC I received excellent care and would not have considered going anywhere else. I was treated with care and attention and made to feel that no worry or concern was unfounded. For the time I spent on the ward I was made to feel at home. Being able to have an uninterrupted bath or a few hours sleep while my babies were care for was invaluable and I always recommend ABC to expectant mothers that I come into contact with.
I love Ashcombe Birth Centre - the relaxed atmosphere, the midwives are very accommodating even offering me a hot drink in the middle of thenight - these small gestures mean a lot. All midwives were so helpful and friendly, they couldn't do enough. The cleanliness is brilliant, my room was cleaned twice daily regardless of whether it needed it. All staff were lovely including cleaning and meal staff. The only fault I can think of is there is a huge pressure to breastfeed - I completely understand targets and I wanted to breastfeed so it didn't phase me but I think it could put other women off. Overall I am always impressed with Ashcombe and would urge other new mums to have their babies in Weston.
I was due to go to Southmead but upon calling them they told us they were full and would call us back. When they did, we were asked if we would mind going to Weston. This was fine with us as we live in Nailsea which isn't too far. I had a short labour and a water birth. From start to finish I had a great experience - the staff were kind, the environment was relaxed and I couldn't have wished for a better after-birth care. I am very glad that Southmead was full - if I do have any more children I would go to ABC and would highly recommend it.
2nd baby - much better experience than 1st (not born in Weston). Would defo recommend and would go here again if ever had another. Lovely staff very caring and felt like they had all the time to help me. Had a few problems getting baby to feed but thanks to the midwives help we got him feeding and are still going 3 months later. Can’t thank you all enough and would highly recommend you.
One of the individual rooms doesn’t have a sign up saying if you're hungry ask for food - I was really hungry but didn't like to ask after having my baby. Initially I couldn't keep food down but overnight was then really really hungry - a sign in the room would be good. I was given so much help with feeding (which was needed as baby kept forgetting how to!) - I’m so grateful. I was very very grateful to stay in longer as I felt so ill having lost so much blood and previously being ill before delivery. The baths could do with handles to pull yourself up as I got stuck and couldn't pull myself out initially post delivery (had to be helped out). Delivery rooms could do with clear instructions in them for the community midwives that occasionally use them as I had a community midwife not normally there and it wasntt obvious how to run the birthing pool tap or stop it or where to find the thermometer etc. I was very grateful ABC was there to support me and baby H**** and it made the experience amazing instead of awful like previous birth in Bristol when they didn't have a midwife or labour room so THANK YOU. Overall a 10 for everything - the comments are just for feedback of my experience - THANK YOU FOR ALL THE HELP!
We thought everybody was lovely! Thank you very much. I was a case study for N**** K**** - she was amazing from start to finish - the best midwife I've had. I will miss her now - massive thanks to N****.
The staff at Ashcombe were warm and encouraging and enabled me to take control of my labour - I felt they respected my space and I found it a wonderful calm experience. The environment created in the birthing pool room was beautiful and allowed for a natural spiritual experience of giving birth so my son - thank you. Afterwards I would have stayed had I not had to travel to St Michael’s for stitches. What a shame this was not something that could have been done in Weston. My husband had to take our newborn baby up to Bristol in the back of our car instead of him coming in the ambulance with me on a hot day with no sat nav to guide him - this put him under immense stress and sadly spoiled what had been such a wonderful positive experience. On the whole, with this exception I would recommend Weston and ABC.
As a first time mum, I was very nervous during the labour but the midwives involved in my delivery were patient, kind and very reassuring which helped me to have a very positive experience. I stayed in for 3 days and each midwife I had contact with was friendly and had time to answer my many questions! I would highly recommend the Birth Centre to friends and family. Thank you for supporting my husband and I during this amazing time.
Absolutely brilliant. Just wish I was listened to when I wanted the birth pool filled up, they said it was too early but baby arrived soon after and I never got to use it.
Kirsty is the most fantastic midwife I have ever met! She made me laugh, was supportive and was always so happy to help. I am so thankful that I had her during my labour. She is a member of staff you should never slip through your fingers. Please pass onmy thanks to her again and let her know baby J***** is doing really well and is forever smiling and still has lots of hair.

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