Opinion  

The government's new maternity care policy, Maternity Matters, is an achievement for the whole maternity care community. Direct access to midwifery services, individual care plans, community-led antenatal care and choice of place of birth, are essential to providing women with the accessible, flexible and responsive care they need during their pregnancy.

The National Childbrith Trust (NCT) has been lobbying for midwives to have a higher profile and women to be able to book directly with a midwife, for over 10 years. We believe this will enable women to access the information and support they need earlier in pregnancy and have a better chance of being offered a full range of choices.

Directing policy at local level care
In particular, Maternity Matters highlights the need for accessible, integrated services in community settings, and continuity of midwifery care. It is refreshing to see national policy recognising the importance of local services and how this benefits women. All too often we hear from women in rural communities or from disadvantaged backgrounds who cannot access the care they need, because of long, difficult journeys, staff shortages, lack of information or a restricted range of services.

Maternity Matters addresses the need to identify and address social as well as medical needs early in pregnancy and develop responsive services to meet those needs. All local health agencies must work together to ensure that services are well integrated and referrals can be made easily between teams.

Sure Start Children's Centres provide an excellent venue for delivering many antenatal and postnatal services. Midwifery, health visiting and family support services will increasingly be run from these community-based settings, with access to more specialist services on-site or via direct referral.

Focused services will be offered to women and families with complex needs, including those with a history of mental health problems and drug misuse.

Antenatal services, classes, breastfeeding drop-ins and parent-to-parent support groups should all be extended, along with a more flexible approach to postnatal care.

Implementation concerns
Maternity service liaison committees (MSLCs) have been promised a strong, central role, which will give them, and maternity service users working on them, scope to plan, prioritise and develop the range and direction of local services. However, MSLCs can only work effectively if they are fully supported by PCTs and engage both users and managers. Often joint training and team building sessions make a huge difference to how well these groups work together.

With continuing pressure on resources, it seems highly likely that tension will arise when trying to prioritise between extending choices and delivering safe, high-quality care. We have been assured that while PCTs do not have ring-fenced funds, they should have sufficient money to implement the proposals over the next few years, starting immediately with their strategic needs assessment to identify priorities.

It's not going to be easily achieved, but the NCT is committed to working closely with the DoH and the maternity care community to make Maternity Matters a reality.

Mary Newburn is head of policy at the National Childbirth Trust and honorary professor at Thames Valley University. She trained as an NCT antenatal teacher before becoming a member of staff in 1988. The Policy Research Department at the NCT is involved in all aspects of maternity care including promoting woman-centred, evidence-based care.

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