Working together to make maternity and neonatal services more inclusive and accessible

This blog comes from Jo Baker and Sonya Ainley

We’re excited to share the outcomes of our work to review our maternity and neonatal services and support. This is a real example of co-production and collaboration in action leading to real change and improvements across our Local Maternity and Neonatal Services (LMNS) in West Yorkshire and Harrogate.

This work was a partnership between our Power of Communities Programme and the WY&H LMNS, recognising our shared commitment to learning and continual improvement through listening to the people delivering and using our services. At the heart of this work was a desire to ensure services are more inclusive and accessible, and better meet the expressed needs of our diverse population, breaking down barriers and building on good practice across the system.

We began this work in summer 2022 with an ambition to listen to the views and experiences of both our health and care staff and volunteers, and people who had recently used our services in West Yorkshire, to understand what we might do better or differently to improve the maternity neonatal journey for everyone involved.

What we did

In August 2022 Thrive by Design (an agency focused on tackling digital health inequalities) facilitated a full day face-to-face session, bringing together 23 people with different experiences of our services, including mums and dads, refugees and asylum seekers, VCSE (voluntary, community and social enterprise organisations), midwives, maternity services staff and specialist midwives, and other health and care staff.

Together we explored and shared our different life experiences before pregnancy (pre-conception), pregnancy (antenatal), labour and birth and after baby is born (postnatal/neonatal). We listened to each other, we laughed, and we cried, but most of all we thought about what we could do to make things better for everyone.

There were some examples of much valued practice in West Yorkshire and Harrogate including the doulas (advocates/ birth supporters), birth centres, peer to peer support groups, and a reflection that experiences were so much more positive when people felt listened to and respected.

From our conversations the following areas for change were identified along the maternity neonatal journey, which members of the group felt we could strengthen or do differently:

What has changed?

1) More accessible information for dads and partners, including around mental health:

• DadPad app for new dads and dads-to-be
• Launch of Paths, West Yorkshire’s perinatal maternity mental health service
• Local initiatives at some Trusts

2) Information about miscarriage and local support offers:

• Trust bereavement midwives
• LMNS bereavement booklet
• Tommy’s and Sands information

3) Information in different languages and formats

• LMNS / Trust information is reviewed on a rolling basis with maternity Neonatal Voices Partnership (MNVP) including accessibility
• Individual Trusts have developed local initiatives e.g. videos, translated leaflets in different languages and formats

4) A list or map of information, resources and organisations in our voluntary, community and social enterprise sector (VCSE) which offer support or services across the maternity and neonatal pathway4

• An external consultant based in the VCSE was commissioned to develop a map of existing services and support available through our VCSE across West Yorkshire and Harrogate
• 18 directories were reviewed; over 80 individuals contributed; and partnerships and individual organisations were contacted
• The result is an online directory which provides an overview of what is currently available. You can access that via this link: https://cloud.seatable.io/dtable/view-external-links/custom/Viewmatmap/

What next?

We are also continuing work to: 

• Ensure the maternity and neonatal services directory is shared widely, kept up to date and reviewed regularly
• Ensure all staff are trauma informed - we are working with the Integrated Care Board’s (ICB) Adversity, Trauma & Resilience Team and developing a training plan for our LMNS workforce
• Explore wider investment in and access to doulas across West Yorkshire - currently the financial context across health and care has meant we have been unable to identify further funding. But this remains an ambition for the future
• Explore the wider use of interpreters, or a suitable alternative where this is not available, for those for whom English is an additional language to ensure women understand what is happening to them and their baby at every stage of the maternity journey. Some Trusts are already introducing new interpreter resources that are available 24/7 but we recognise the need to develop a more consistent approach across the whole system.

A big thank you to everyone who contributed to this work. It was a real example of collaboration and co-production in action and has helped us make our services more accessible and inclusive. We would also like to acknowledge the contributions of Karen Poole, Associate Director for Maternity Transformation who retired in May, in making this happen.

Thank you for reading.

Jo Baker and Sonya Ainley