Maternity Choice

We heard from 403 Maternity service users across North East London through a survey between December 2022 and February 2023. 

We are still seeing an ongoing division in maternity experience relating to health inequality. Service users from Black African, Turkish, Pakistani and Eastern European communities are less likely to experience choice of maternity unit (patients who self refer online can choose where they have antenatal appointments and where they give birth). Referral by a GP seems to lead to a lower level of choice and co-production experienced by Maternity service users than self-referral. Fluency in English is a well-known marker of inequality, and we see this here; being a single parent, although now less stigmatised, remains a marker of inequality.

Respondents of Black ethnicities experience a double barrier to maternity care because they are more likely to value cultural symmetry but less likely to experience this. Polish and Pakistani respondents were less likely to report having access to professionals who speak their language.

Recommendations 

• Creating greater awareness of the nature of health inequality across North East London. 

• Further research into GP referral structures. 

• Further research into self-referral choice mechanisms. 

• Management of capacity issues within antenatal provision. 

• Clear information about antenatal waiting times and the impact of delayed arrival. 

• Cultural sensitivity training for Maternity staff caring for service users from Black, Polish and Pakistani communities. 

• Interpreting services for any service user with less than conversational English. 

• Improved parking facilities where a car is the main mode of transport.