Maternity Guides

Aim:

To gain greater understanding of maternity services, empower BME women to improve services for their communities and create a network through which local BME women with young children can support each other.

About the project:

The project is about engaging BME pregnant women. The project will follow the journeys of the women using maternity services to pick up any problems with services and will provide training to the women involved in raising these issues with service providers and with consultation structures such as the Maternity Services Liaison Committees. The project will also lead to a sustainable support network for BME women with young children who are under-represented in national support networks such as the NCT (National Childbirth Trust). This network will work across a partnership of BME community organisations and will provide these organisations with expertise on accessing maternity services as well as a support network for their members.

It is recognised that women with young families are a hard to reach group because they have great demands on their time. The project has therefore made allowances for providing money for childcare as it is recognised that without such resources it will not be possible to engage these women.

Background

The project has been put together because the BME Health Forum has concerns that BME women are not always receiving maternity services that meet their needs. Locally, in recent years there have been anecdotal reports to the BME Health Forum that BME women are not satisfied with maternity services from St Mary's Hospital. At a national level, there have also been reports that BME women report poorer experience of maternity services and suffer from worse maternal and infant outcomes. For example:

The Health Care Commission report 'Towards Better Births' states with regard to women of Black and Asian origins 'they are less likely to be booked within 12 weeks, they felt they had less choice as to where to have their baby and they were less likely to have a scan at 20 weeks'. Furthermore, 'they had less confidence in the staff during labour and birth and were more likely to be left alone and worried by it.' (Healthcare Commission, 2008 pp. 78).
The same report found that women from BME groups have a greater risk of poor maternal and infant outcomes such as needing to stay in hospital for longer and having their baby cared for in a neonatal unit (Healthcare Commission, 2008 pp. 92).
The stillbirth rate and neonatal mortality rate are higher for women of Black, Asian or Other ethnicity. (Centre for Maternal and Child Enquiries, 2004, p. 6).
Women from ethnic groups other than White have, on average, three times higher peri-natal mortality than White women. Black African women, including asylum seekers and newly arrived refugees have a mortality rate seven times higher than White women and have major problems in accessing maternal health care.' (Confidential Enquiry into maternal deaths, 'why mother die?' 2002, p. 26). This report also raises issues about the risks involved when family members are used as translators (Confidential Enquiry into maternal deaths, 'why mother die?' 2002, p. 47; 210).
There is also anecdotal evidence that BME women are less likely to join formal maternity support networks such as the NCT or patient involvement mechanisms such as the Maternity Services Liaison Committees. While some BME women who do not join such groups may enjoy a lot of community support from friends and family, the Forum has concerns that some BME mothers are less aware of these networks, and may feel excluded from them because of lack of funds or from a perception that such groups 'are not for them'. Furthermore, national support networks may not always cater for the needs of BME women, particularly women who are new to the country and who are not fluent in English. This project aims to give BME mothers the support to form their own support network and to empower them to join Maternity Services Liaison Committees so that their views about improving services can be heard.

Main Outputs

Form an advisory group of interested community, voluntary and statutory organisations, including NHS commissioners and the Maternity Services Liaison Committee which will meet regularly to provide steer for the project.
Recruit 10 BME women who are pregnant (including women who are not yet fluent English-speakers)
Provide the women with training about recording their experiences with maternity services (e.g. waiting times, information received/ requested, interaction with staff, access to appropriate services, clinical care & choices, collection of ethnicity and language data, access to interpreters)
Hold regular support/feedback meetings with all the women involved in the project.
Provide interested women with training about attending consultations, having their voices heard and how they can use their skills further to guide and influence stakeholders and champion the findings of the report.
Produce a report and articles relating what the project has taught us about maternity services and how the services can be improved.
Support women to join the Maternity Services Liaison Committee, and other patient groups to champion the findings of the report.
Support a sustainable support network of BME women with young families which will operate across the BME Health Forum organisations and provide expert information to BME communities.

It is recognised that women with young families are a hard to reach group because they have great demands on their time. The project has therefore allocated resources for paying a small fee to the women engaged in the project and for providing money for childcare as it is recognised that without such resources it will not be possible to engage these women.

Project measures and outcomes

Outcome 1: Gain a greater understanding of maternity services and disseminate the findings.

Measure 1: A report will be produced at the end of the project detailing the findings of the project including recommendations.

Outcome 2: Empower local BME women to champion the findings of the report.

Measure 2: At least 8 women will receive training about how to raise their concerns with service providers or patient involvement networks

Measure 3: At least 5 women will join the Maternity Services Liaison Committee.

Outcome 3: Create a network of BME women from different communities who are pregnant/ have young children who can provide expertise to the BME Health Forum organisations on maternity services and support and mentor other women using maternity services.

Measure 4: At least 5 women will form the core of a network to provide expert information to organisations with regard to maternity services and to support and mentor other women using maternity services. More women will be recruited gradually.