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Poorer mothers 'get worse care'

More needs to be done to help poor women through pregnancy, experts have said after new research found that they have a worse experience than better-off mothers-to-be.

Researchers from Oxford University analysed the 2010 National Maternity Survey, which included findings from more than 5,300 women who had given birth in England.

The study, published in BJOG: An International Journal of Obstetrics And Gynaecology, found that the most deprived women were 60% less likely to have received any antenatal care when compared to the richest women.

These women were also 38% less likely to have been seen by a health worker in the first 12 weeks of pregnancy and 47% less likely to report being able to see a health worker as early as they desired in their pregnancy.

And poorer women were more likely to report that they were not treated respectfully by health workers or spoken to in a way that they could understand during antenatal care and labour.

Study co-author professor Marian Knight said: "There is a need for careful planning and development of strategies to address the possible reasons for these differences in healthcare delivery and outcomes .

"The findings from our analysis suggest that several factors may collectively contribute towards poorer maternal outcomes amongst women from the lowest socio-economic groups.

"These include unplanned pregnancy, no antenatal care or late engagement with antenatal services, transfer during labour, higher Caesarean section rates and poorer communication with healthcare professionals."

Commenting on the study, Dr David Richmond, president of the Royal College of Obstetricians and Gynaecologists, said: "The results of this study show that not enough women are seeking the antenatal and postnatal care that they need. The research also raises concerns where the quality of maternity care requires improvement.

"Pregnancy can be a worrying time and we need to make sure all women are accessing the right help and support.

"We have known for some time that pressure on maternity services is growing in some areas, particularly inner city conurbations, placing stress on units. More consultants and midwives are needed to provide the standards of care we recommend 24 hours a day, especially given the rise in complex pregnancies."

Louise Silverton, director for midwifery for the Royal College of Midwives, said: "The challenge is that this group of women are the same women who do not have a voice, unlike a lot of women we see in our clinics. This group ask for little and get little, often because they do not know what services are available.

"Midwives around the country have shown that with continuity of care, kindness and empathy, the health outcomes for socially disadvantaged women dramatically improve.

"These women should have more access to a midwife, but this is not possible because of stretched NHS resources and the pressure on their time. Ideally, socially disadvantaged women need longer antenatal and postnatal appointments than are currently available. We need more midwives to address these challenges and provide continuity of care."

A Department of Health spokesman said: "All women should receive the best possible care during their pregnancy, regardless of their circumstances. Since 2010 we have introduced 1,700 more midwives, with 6,000 more in training and we are also making sure every woman has a named midwife to ensure personalised care throughout pregnancy."

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