Birth Trauma Inquiry: Improving maternity services using digital
On 9 January 2024, the All-Party Parliamentary Group (APPG) on birth trauma in the UK set up an inquiry to investigate the reality of maternity services across the country, focusing on the reasons for traumatic births. This inquiry involved focus groups, interviews with grieving and trauma-stricken patients, and the over-worked and highly pressured staff who live this trauma day in and day out. The desired output? The development of policy recommendations to reduce the rate of birth trauma and ensure a fair experience for all regardless of race, religion, location or wealth.
The Birth Trauma Inquiry has now been concluded and it contains some harrowing stories of heartbreak, loss, and trauma. The outcome from the inquiry is an 80-page report that outlines key changes needed in the sector to provide a fair and accessible experience for all prospective parents no matter where they live, covering the entire journey from pregnancy through to parenthood. To help you digest the inquiry report, we’ve highlighted seven key conclusions and matched them to seven digital solutions that can help maternity services meet these recommendations.
1. Recruit, train and retain more midwives to ensure safe levels of staffing in maternity services.
This training will also include mandatory training on trauma-informed care and will extend to obstetricians and anaesthetists. Under current practices, recruiting and training costs an NHS Trust £12,000 per nurse. This cost combined with the time taken to recruit, onboard and train staff puts the NHS recruitment crisis in a whole new light. Focusing on retaining and training midwives in order to increase the number of staff on shift at any one time will reduce the strain on maternity services and put more staff at the helm when dealing with traumatic birthing scenarios.
The solution: An enhanced employee experience that fosters continuous improvement, staff engagement and boosts staff retention. Through the use of efficient and effective staff onboarding, both clinical and non-clinical employees feel engaged and involved right from the beginning of their employment and staff retention increases.
2. Commit to tackling inequalities in maternity care among ethnic minorities, particularly Black and Asian women.
Many reports over the years, including investigations from the charity Birthrights, have highlighted racial injustice for women under maternity care. For example, black woman are four times more likely than white women to die during childbirth, and Asian women are twice as likely. Far too often, women have reported feeling unsafe, being denied pain relief, and faced racial stereotyping about their pain tolerance. This stems from stereotyping and a lack of cultural competence and negatively impacts a person’s ability to speak up about the care they’re receiving.
The solution: Make content and services accessible to all, and available in any language to minimise opportunities for racial discrimination, making all prospective parents feel at ease during their pregnancy journey. This can be facilitated through an easy-to-access maternity portal that translates content and enables the patient to raise complaints or give feedback about the service they’re receiving.
3. Training and procedure documents need to be more accessible for staff to reduce the amount of injuries in child birth.
Even in a digitally adopted world, clinicians often don’t have easy access to a computer when on the ward. This means the use of procedure documents and guidelines are often time consuming or hard to access, especially in times of need such as during traumatic birth situations.
The solution: An easy-to-access staff intranet that provides employees with the latest policy and procedure documents anywhere, anytime and on any device. Put the power back into employees’ hands and adhere to compliance and regulations by making documents more accessible to staff. A great staff intranet also encourages community and learning, helps share general news and education like announcements and blogs, and provides staff with one source of the truth and a hub of conversation and information – all facilitated through their mobile phone.
4. Link to mental health services and enable people to have standardised post birth services like birth reflections and 6-week check-ins.
After traumatic births, parents are offered a birth reflection to discuss their thoughts and feedback around the service they received and the impact the traumatic birth has had in understanding what went wrong. These sessions can often feel rushed and both clinical staff and the parents themselves either do not feel satisfied with the discussion that took place, or are under-prepared for the conversation itself.
The solution: Providing the ability for parents to complete birth reflections and check-in information in their own time prior to their appointment. This would enable parents to take their time to think about their response, and ensure they’ve covered everything they need to. It would also ensure appointments are used to discuss the information as opposed to gathering it, helping make the sessions more efficient. This could be facilitated through online forms, accessed through a personalised maternity portal that only they have access to.
5. Information and permissions need to be agreed prior to labour to eliminate women having to fill in forms in the middle of labour.
In worst case scenarios, consent forms are required for clinical staff to administer drugs or undertake procedures such as epidurals and c-sections. Often, these forms are completed by the patient on paper, in high stress environments and during a time where cognitive understanding of the possible risks and complications of these forms is impaired.
The solution: Ensure all possible forms required for various situations and circumstances that could arise during labour are already signed via a digital portal ahead of time. This gives clinical staff easy access to consent forms and policies to save administration time during stressful situations, and also alleviates the need for women to sign these types of consent forms when possibly cognitively impaired.
6. Ensure better education for women on birth choices. All NHS Trusts should offer antenatal classes, risks should be discussed during both antenatal classes and the 34-week check.
Antenatal classes are the most common form of education for prospective parents across the UK. However, these are paid for classes, delivered by non-medically trained staff from a variety of third-party organisations. This format of paid-for education often means that those who cannot afford the classes miss out on the same experiences and education as those who can. This has created a clear divide across geographic locations and ethnicities who are being unfairly affected by a lack of accessible education.
The solution: A maternity portal that provides access to free and paid for NHS antenatal classes and clinically-led education to help inform prospective parents. Content can be consumed in their own time via any device, and nobody is excluded based on ability to pay. This also generates income for the maternity service based off classes that are paid for and helps reinvest that income to provide free support and education to ensure equality in the services provided.
7. Provide support for fathers and ensure nominated birth partners are continuously informed and updated during labour and post-delivery.
Often, family members, fathers and birth partners are not as involved in the pre-delivery education, with antenatal classes and support primarily being offered to the mother during the pregnancy journey. This recommendation would ensure that everyone is informed and educated to the same level, which can help provide further support to the prospective parents at all stages of their experience.
The solution: Enable fathers, birth partners, friends and family access to a maternity portal that enables communication both pre and post-delivery, enabling them to provide feedback on the service they received, and keep up to date and informed throughout the entire pregnancy journey. This portal can be accessed 24/7, on any device and allows the user to educate themselves in their own time.
Delivering better outcomes through digital
Digital tools and technologies have the potential to alleviate the strain on maternity staff whilst still delivering a higher quality service to expectant mothers, birth partners, friends and family. Whether this starts from recruitment and focuses on improving staff retention to ensure better staffing rates, or alleviates the strain of education and ensures fair and equitable access to antenatal classes for all - digital solutions have the power to elevate your maternity service.
Although the inquiry has made many recommendations and driven a major call for change across the country, one conclusion stands clear. The UK’s maternity sector is over-worked and under resourced and change needs to happen to ensure a fair service is offered to all prospective parents across the UK without prejudice. Technology has the power to make this happen, and make it happen at scale, without causing a major strain on the already tight resources of the NHS.
To understand more about how digital solutions could enhance the offering of your maternity service, get in touch with the team today or check out our webinar aimed at Maternity services to help them discover how other NHS Trusts are using digital solutions to enhance the patient experience.