Midland Regional Hospital Portlaoise.
Most women gave birth in the Midland Regional Hospital Portlaoise have a positive experience of maternity care but this satisfaction level is below the national average recorded in the first survey of women who have given birth in Irish hospitals.
The newly published National Maternity Experience Survey had over 3,200 respondents nationally. A total of 245 women who gave birth in the Laois unit in October and November 2019 were invited to participate in the survey. 123 women
completed the Health Information and Quality Authority (HIQA) run survey.
HIQA's report said women were asked to rate their experience under a number of headings answering several questions. Overall, 78% of women who delivered in Portlaoise said they had a good or very good overall experience. This compares with 85% nationally. Exactly half said they had a very good experience in Portlaoise which is a little below average. Just over 20% said they had a 'fair to poor' experience in the Laois unit.
The top out of ten score was for care during labour and birth.
- Key ratings out of 10
7.4 Care while pregnant
8.6 Care during labour and birth
7.5 Care in hospital after the birth
7.6 Specialised care
8.3 Care at home after the birth
Half of those who took part were from Laois, a quarter were from Kildare with just 11% living in Offaly. A small number of women from Tipperary, Wicklow and Carlow were surveyed.
The survey report said that cross each stage of care from antenatal care through to postnatal care at home, women who gave birth in Portlaoise rated their care as similar to the national average.
Women’s ratings of the care their baby received in the neonatal unit were significantly above the national average. All 12 women who answered heir experience of the care their baby received in the neonatal unit as good or very good. 92% of women said that they had a very good overall experience of the care their baby received in the unit. This was higher than the national average of 70%.
The report says women who gave birth in Portlaoise rated their antenatal care as about the same as the national average. The highest-scoring question for this stage related to respect and dignity while pregnant, with 75.6% of women saying that they were always treated respect and dignity while they were pregnant.
The lowest-scoring response related to information about mental health, with 35.0% saying that they did not receive enough information about changes in their mental health while they were pregnant.
Women rated their care during labour and birth as about the same as the national average. The highest-scoring question for this stage related to the involvement of a partner or companion, with 95.7% saying that their partner or companion was as involved as they wanted them to be in the labour and birth.
The lowest-scoring question related to involvement in decisions during labour and birth. 21 women (17.1%) said that they
were not involved in decisions about their care during labour and birth.
Three-quarters of women said they were not left alone by healthcare professionals at a time when worried during Labour. Of those who said they were 14% said they were left alone shortly after birth.
Women rated their care in hospital after the birth as about the same as the national average. The highest scoring question for this stage related to being told who to contact after discharge, with 87.9% of women saying they were told who to contact if they were worried about their own health or their baby’s health.
The lowest-scoring question related to ‘debriefing’, with 40 women (37.0%) saying that they did not have the opportunity
to ask questions about their labour and birth after the baby was born.
Women who gave birth in Portlaoise rated the ‘Feeding’ questions as about the same as the national average. Most women (74.0%) said that their decision about how they wanted to feed their baby were always respected by their healthcare professionals.The lowest-scoring question for this stage related to support and encouragement with feeding at home, with 21
women (21.4%) saying that they did not get adequate support and encouragement with feeding their baby at home.
Women rated their care at home after birth as about the same as the national average. The highest scoring question for this stage related to clear answers from the public health nurse, with 86.9% of women saying that their questions were answered by the public health nurse in a way that they could understand. The lowest-scoring question related to the time spent by the GP or practice nurse/midwife discussing mental health at their six-week check-up, with 23.3% of women saying that there was not enough time spent discussing their mental health at this check-up.
Questions were also asked about involvement in decisions, confidence in staff, and respect and dignity. The highest-scoring question related to being treated with respect and dignity at home after the birth, with 86.2% saying that they were always treated with respect and dignity at home.
The lowest-scoring question related to involvement in decisions while pregnant, with 53.7% saying they were always involved in decisions about their care during their pregnancy, and the remaining women saying that they were only sometimes involved or not involved in decisions.
HIQA say it is notable that midwives feature strongly in an analysis of women’s comments. It says there are many more positive comments than suggestions for improvement relating to midwives, which likely reflects the nature and importance of
the interactions that women have with midwives during labour and birth.
HIQA’s Director of Health Information and Standards Rachel Flynn said of the national survey: “Our maternity services must be responsive to the needs of women. Thousands of babies are born in Ireland each year to women who will all have a unique story to tell about their care during pregnancy, childbirth and at home with a newborn baby.
“It is only by listening and learning from the experiences of Irish mothers that we can bring about effective and sustainable changes to our maternity services, and put women and their babies at the centre of maternity care. I wish to thank all of the women who took the time to respond to the survey and share their experiences of maternity care.”
Responding to the national findings HSE CEO Paul Reid said: “We are very grateful to all the women who participated in the survey. As well as publishing the survey results today, we are also publishing the response of our community and hospital teams to the findings. Each maternity hospital and Community Healthcare Organisation has developed a quality improvement plan with clearly-defined actions to improve maternity care.
“At a local and national level we are committed to making and monitoring these changes. We are clear about our priorities for perinatal mental health, feeding support and health information at every part of the maternity journey.”
INMO General Secretary, Phil Ní Sheaghdha, said: “It is clear that midwives’ work is incredibly valuable to all those in their care. The whole midwifery profession can take pride in how highly their skills are valued.
“But understaffing evidently has a real impact on patients. Despite population growth, the number of midwives has barely budged in recent years. Existing midwife-led services have been threatened, with little rollout of new services.
“There is still no funded plan to get the midwifery workforce to safe and appropriate levels. Women clearly deserve better: the current medically focused model can rush women through, leaving many without the aftercare they need.
“Midwifery can provide woman-centred care, with genuine options of midwife-led care at home or in maternity hospital. But they need the staffing levels to do it,” she said.
The report on the findings of the 2020 National Maternity Experience Survey, and the HSE’s quality improvement plans (QIPs), can be found at www.yourexperience.ie.
The Portlaoise report is available here https://yourexperience.ie/wp-content/uploads/2020/09/MidlandsRegionalHospitalPortlaoise_NMES_QIP_2020.pdf