Service users' experiences of maternity care in England informed by the Saving Babies' Lives Care Bundle Version 2: A reflexive thematic analysis

Abstract

Background: In 2019, NHS England launched the second version of the Saving Babies' Lives Care Bundle (SBLCBv2), recommendations that maternity providers are expected to fully implement, in an ongoing effort to reduce stillbirths and preterm births. Although stillbirth rates have seen an overall significant reduction since the inception of the SBLCB, experiences of maternity care in England are deteriorating. This study aimed to explore service users' experiences of SBLCBv2-informed maternity care to help understand the aspects of care they received positively and those needing improvement.

Methods: This qualitative study captured service users' experiences of receiving maternity care across England between November 2022 and December 2023. Purposive sampling was employed to include service users from diverse backgrounds with a variety of experiences of each element of SBLCBv2. Participants (n=29) were 16 years or older, had given birth within the previous 12 months and could comprehend and speak English. Semi-structured interviews were conducted via video call and the data analysed using reflexive thematic analysis.

Results: Four main themes with nine subthemes were developed: (1) feelings towards measuring and monitoring, (2) the importance of clear communication, (3) healthcare professionals' roles in decision-making and (4) belief in service users, trust in healthcare professionals. Each theme is discussed in relation to the five elements, and the 'Important Principles', of SBLCBv2.

Conclusions: Our findings echo maternity care needs reported elsewhere in the literature, suggesting the interventions introduced in SBLCBv2 are generally acceptable but that information about SBLCBv2 must be personalised, and clearly presented, to each individual. Professionals play an important role in service users' decision-making, and participants' perceptions of how collaborative and supportive professionals were in decision-making processes varied. Believing service users and trusting professionals are of paramount importance for ensuring service users have positive maternity care experiences.

Keywords: communication; obstetrics and gynecology; qualitative research; shared decision making; womens health.