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Experiences of maternity care in NSW public hospitals: January to December 2015

Maternal and infant welfare Hospitals Childbirth New South Wales

Provides detailed information about the experiences of care for women during various stages of the maternity journey, highlighting where NSW performs well, and potential areas for improvement.

Key Findings:

1) A statewide survey of 4,739 women who gave birth in a NSW public hospital in 2015 shows t hat most had good experiences of maternity care – 79% said they would speak highly about the hospital where they had their baby. Women responded more positively about their experiences during labour and birth; and less positively about postnatal hospital care – a finding consistent with surveys in other jurisdictions.

2) Access to important elements of care, within recommended timeframes, differed. For example, 40% of women said they had their first antenatal appointment before the 14th week of pregnancy. Administrative records for the same indicator show that among public hospital births, 57% of women received antenatal care before 14 weeks. More positively, 95% of women said they saw a midwife or nurse in the two weeks after they left hospital. Most (80%) said their length of stay in hospital was ‘about right’ however 13% said it was ‘too short’.

3) Most women received key information and advice about safe sleeping for their baby. However, almost three in 10 women said they were not given advice during antenatal visits about healthy weight gain; and around one in 10 were not told about the risks of alcohol consumption; or exposure to tobacco smoke.

4) In line with current best practice, almost all women had skin to skin contact with their baby shortly after birth. A high proportion of women – about nine in 10 – said they were given enough privacy during labour and birth; and received breastfeeding support.

5) Most women said they were engaged in decisions about their care – about seven in 10 said that during labour and birth they were ‘definitely’ involved in decisions (as much as they wanted to be); and a similar proportion said they were ‘definitely’ engaged in decisions about their discharge home.

6) In terms of patient-reported outcomes, 22% of women said they experienced a complication w hile in hospital or shortly after they were discharged – most commonly reported were infection (8%) and excessive bleeding (7%). A higher proportion of women who had a caesarean section said they experienced a complication than women who had a vaginal birth (28% and 20%).

7) Across local health districts (LHDs), responses from women who gave birth in Southern NSW were s ignificantly more positive than NSW results; and those from women in South Western Sydney were less positive. At a hospital level, responses were more positive for Ryde and Wyong and less positive for Fairfield.

8) The question for which there was greatest variation across hospitals was related to time spent waiting to be seen at antenatal appointments. Other questions with marked variation addressed overall experience of postnatal care in hospital, and cleanliness of toilets and bathrooms.

9) Women who gave birth to their first baby, and women who had a caesarean section r esponded to many survey questions less positively.

10) There are a limited number of maternity surveys available for benchmarking. Three surveys (Queensland, England and Scotland) altogether contained 26 comparable questions and of these, NSW had the most positive result for six questions and the least positive for four questions.

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