Scope and focus

This report focuses on understanding women's experiences of maternity care in Kirklees, with a particular emphasis on amplifying women's voices and strengthening advocacy as a way of reducing inequalities. It explores how factors such as ethnicity, deprivation, language barriers and lived experience shape access to care, experiences of services and outcomes for women, babies and families.

The report brings together national evidence, local data and lived experience to highlight where inequalities exist and where improvements are needed. It places a strong emphasis on the role of advocacy, both formal and informal, in supporting women to be heard, understood and appropriately supported throughout their maternity journey. 'Advocacy' in this context refers to support provided by another person to help women have their voice heard, understand their choices, express their views and preferences, access the support they need, and ensure their rights, needs and wishes are recognised and respected throughout their maternity journey.

What does good advocacy look like?

Good advocacy helps women to:

• Understand information and choices in a way that makes sense to them.
• Ask questions and feel confident expressing their views.
• Make informed decisions about their care.
• Have their concerns listened to and acted upon.
• Access the services and support they need.
• Receive care and support that is culturally responsive and appropriate to their individual needs and circumstances.
• Be treated with dignity, respect and compassion.
• Influence how services are designed and improved through sharing their experiences.

Women have different needs, preferences and levels of confidence when accessing services. Some women are comfortable advocating for themselves, while others may benefit from additional support to ensure their views, wishes and concerns are heard. Factors such as language, culture, disability, previous experiences, confidence, health literacy and wider social circumstances can all influence how able a woman feels to ask questions, express her views or challenge decisions about her care.

However, advocacy is not only about helping women to speak up. Many women are able to clearly communicate their views and preferences but may still experience barriers to being heard, believed or involved in decisions because of power imbalances within systems and services. Good advocacy can help address these barriers by ensuring that women's voices are listened to, respected and acted upon, regardless of their background, circumstances or level of confidence.

Good advocacy can be provided formally through specialist advocacy services, peer support programmes and community organisations, or informally through trusted professionals, family members, volunteers and community champions. Advocacy will not be needed by every woman in the same way, but all women should have access to care and support that enables them to feel heard, respected, informed and empowered to participate in decisions about their health and care.

This report does not provide a detailed clinical or operational review of individual maternity services or assess the performance of specific organisations. It does not replace existing maternity strategies, service specifications or assurance processes. Instead, it provides a focused, system-level exploration of women's experiences, inequalities and advocacy to inform and complement ongoing work across the system.

Within this document we use the terms 'woman' and 'women' to refer to people accessing maternity services. However, we acknowledge that it is not only people who identify as women who access maternity services. We are committed to ensuring that services are appropriate, inclusive and sensitive to all individuals accessing maternity services, regardless of gender identity.