Experiences, utilisation and outcomes of maternity care in England among women from different socio-economic groups: findings from the 2010 National Maternity Survey

BJOG. 2015 Nov;122(12):1610-7. doi: 10.1111/1471-0528.13059. Epub 2014 Sep 17.


Objective: The objective of this analysis was to explore the healthcare-seeking behaviours and experiences of maternity care among women from different socio-economic groups in order to improve understanding of why socially disadvantaged women have poorer maternal health outcomes in the UK.

Design: Secondary analysis of a national survey of women conducted 3 months after they had given birth.

Setting: England.

Sample: A total of 5332 women.

Methods: Logistic regression analysis to investigate differences in outcomes among different socio-economic groups, classified by the Index of Multiple Deprivation (IMD).

Main outcome measures: Healthcare-seeking behaviours, outcomes and experiences of maternity care.

Results: With each increase in IMD quintile (decrease in socio-economic position), women were shown to be 25% (adjusted odds ratio [aOR] 0.75; 95% confidence interval [95% CI] 0.63-0.90) less likely to have had any antenatal care and 15% (aOR 0.85; 95% CI 0.80-0.90) less likely to have had a routine postnatal check-up. They were 4% (aOR 1.04; 95% CI 0.99-1.10) more likely to have had an antenatal hospital admission, 7% (aOR 1.07; 95% CI 0.99-1.16) more likely to have been transferred during labour and 4% (aOR 1.04; 95% CI 0.99-1.09) more likely to have had a caesarean birth, although these results were not statistically significant. With decreasing socio-economic position women were more likely to report that they were not treated respectfully or spoken to in a way they could understand by doctors and midwives.

Conclusions: This analysis suggests the need for a focusing of professionals and services towards pregnant women from lower socio-economic groups and more targeted maternal public health education towards socially disadvantaged women.

Keywords: Index of multiple deprivation; UK; maternity care; socio-economic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Cesarean Section / statistics & numerical data
  • Educational Status
  • England / epidemiology
  • Female
  • Health Care Surveys
  • Health Education
  • Health Services Accessibility / ethics
  • Health Services Accessibility / statistics & numerical data*
  • Health Status Disparities*
  • Humans
  • Infant, Newborn
  • Information Seeking Behavior
  • Maternal Health Services / statistics & numerical data*
  • Midwifery / statistics & numerical data
  • Minority Groups / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Satisfaction / statistics & numerical data
  • Pregnancy
  • Pregnancy Outcome
  • Pregnant Women*
  • Prenatal Care / standards
  • Professional-Patient Relations
  • Social Class*
  • Surveys and Questionnaires