All pregnant women should be encouraged to access maternity services for a full assessment of their health and social care needs, risks and choices early in their pregnancy. The National Institute for Health and Care Excellence (NICE) guidance states that pregnant women should be supported to access antenatal care, ideally by 10 weeks into their pregnancy. This is to give them the full benefit of personalised maternity care and improve outcomes and experience for mother and baby.
Continuity of care (receiving care from the same midwife or small team of midwives) throughout antenatal care, labour, and postnatal care is associated with lower rates of preterm birth and infant mortality. The NHS Long Term Plan set an ambition for most women to receive continuity of care by March 2021.
Here we look at the proportion of women accessing antenatal care in the first ten weeks of their pregnancy, as well as the proportion who report seeing the same midwife for all of their antenatal check-ups.
NICE guidance states that all pregnant women should ideally attend an antenatal booking appointment before 10 weeks of pregnancy. At the booking appointment, women should receive information about routine screening tests, diet and nutrition, and planning for labour.
The percentage of women who attend their booking appointment at 10 weeks of gestation or less has increased over time, from 48% in April 2015 to 64% in March 2021. Over the same time period, the percentage of women who attend their appointment at over 20 weeks of gestation has fallen from 9.6% to 6.9%. This comes alongside an increase in the number of women attending booking appointments, from 31,489 in April 2015 to 65,750 in March 2021 (data not shown).
Continuity of care throughout antenatal care, labour, and postnatal care is associated with improved outcomes as well as a positive experience of care. The Maternity Survey asks respondents “If you saw a midwife for your antenatal check-ups, did you see the same one every time?”. Between 2013 and 2018, the percentage of respondents who reported that they saw the same midwife increased significantly from 34% to 38%. In 2018, 28% of respondents answered “No, but I wanted to”, indicating that there was unmet need for continuity of care.
The question was changed slightly in the 2019 Maternity Survey to ask, “At your antenatal check-ups, did you see the same midwife every time?”. Only 37% of respondents said that they saw the same midwife at every antenatal check-up. These results are not directly comparable with those from previous surveys. Please see ‘About this data’ for more information.
About this data
NHS Digital data
Gestation age at the antenatal booking appointment is collected as part of the Maternity Services Data Set (MSDS) and published in the Maternity Services Monthly Statistics reports. Reports for April 2019 onwards are the first to come from the new version of the data set (MSDSv2). There were numerous changes to the structure of the data set. As a result, data quality and coverage reduced from levels seen in previous publications, so caution should be taken when interpreting the data. All trusts continue to submit data, and completeness is expected to improve over time. For more information, see the Data quality statement.
CQC Maternity Survey
In 2019, question B7 of the Maternity Survey was rephrased from “If you saw a midwife for your antenatal check-ups, did you see the same one every time” to “At your antenatal check-ups, did you see the same midwife every time?”. The number of response options was also streamlined. Respondents who stated that they didn’t know/couldn’t remember or did not see a midwife have been excluded.
Two weights have been applied to the survey results data:
- a trust weight to ensure that each trust contributes equally to the England average, and
- a population weight, to make sure each trust’s results are representative of their own sample and do not over-represent particular groups.
A combination of the two weights results in one single weighting, which has been applied to enable comparisons between years.
For more information, please see the Quality and methodology report.