Women's voices and lived experience in Kirklees

Women highlight difficulties navigating how to access maternity services, particularly when newly pregnant. Experiences of support from primary care are inconsistent, and some women report uncertainty about how to book care or access the right services. Practical barriers, including the cost and complexity of travel to hospital - especially for frequent appointments or neonatal care - can further exacerbate inequalities.

These challenges disproportionately affect women who are new to the country or who face language barriers.

"I am a first-time mum and attended an antenatal appointment at the ... clinic with my partner. We both had to take time off work to attend. Unfortunately, we waited for over an hour to be seen, which was really disappointing. We understand that delays can happen, but the length of the wait had a significant impact on us, especially as we had both arranged time away from work for the appointment."

"I am expecting my second baby and have Type 1 diabetes, so I need regular appointments with both the diabetes team and the obstetric team. I was told that they would try to coordinate my appointments so that I could see both teams on the same day, but this has not happened consistently. Instead, I often have to attend appointments on different days and sometimes in different weeks, which causes a lot of disruption to my daily life and family routine. At times, it feels like I 'live at the hospital'. I would really like to see better coordination between services so that women in my situation can attend one appointment and have everything they need done on the same day, rather than having to make multiple trips back and forth to the hospital."

"I rang my GP to tell them I was pregnant. The person who answered didn't care and she just told me to go online and fill in the form. I said I did not know how to do it, but they didn't help. I rang again a few days later and a different person booked phone call for me and someone rang me back. It was hard and confusing. I am not sure every person like me would know what to do."

[Gathered with a translator] "I have babies in my country, this baby is first one in the UK. It has been very hard because I did not know where to go in the hospital. I was worried and I came to the hospital but I did not know where to go. The first time, I did not know how to get translator. It took me a long time to find where I needed to go because there is nothing in my language. Now I have translator it is good."

Women's experiences highlight the importance of accessible, personalised communication throughout pregnancy, birth and the postnatal period. While many women described positive experiences where staff took time to listen, explain information clearly, provide translated materials or arrange interpreters, others reported difficulties accessing information in a way that met their needs.

A recurring theme was the need for more meaningful conversations and opportunities to ask questions. Some women felt that information was too heavily reliant on written materials, apps or videos, without sufficient discussion to help them understand what to expect or make informed decisions. This was particularly challenging for women who do not speak English fluently, are neurodiverse, or have additional learning needs. Women also identified gaps in antenatal education and preparation for birth, including limited access to interpreters at antenatal classes, which reduced opportunities to fully understand their options and prepare for labour, birth and early parenthood.

Experiences of language support and interpretation services were mixed. Many women valued access to interpreters, translated information and staff who spoke their preferred language, helping them feel informed, reassured and safe. However, others described delays in obtaining interpretation, difficulties understanding information during labour or medical procedures, and concerns that services did not always adequately meet their needs. Communication challenges were particularly significant during labour, birth and emergencies, when clear explanations, reassurance and informed consent were most important.

Together, these experiences highlight the importance of providing information in a range of formats, ensuring timely access to interpretation services, and creating opportunities for personalised conversations that enable women to understand their care, make informed choices and feel confident, included and supported.

"I did not feel well prepared for the possibility of an assisted birth. This was not discussed with me in any detail during my antenatal care, so when it was mentioned later, I felt unsure about what it involved and why it might be needed. I ended up looking for information myself through independent sources to help me understand my options and what to expect. I would have appreciated more information and discussion during pregnancy so that I felt better informed and prepared."

[Husband translated] "Everything has been very good and usually we can get a translator so there are no delays. The staff are kind and they try their best but they do not speak our language so it is hard for them. And it's hard for me to translate because I don't always understand."

[Gathered with a translator] "After a long time in labour I was in so much pain. I speak a little English but when the pains were there it was difficult. Then I met a doctor who spoke my language. I felt safe and it was very good. He helped me."

"I had a c-section which was planned. It was hard to understand the information before and I did not know what to expect. It was confusing, they talked too fast during the operation. After, the placenta hadn't come out properly and I had to go back. They left my baby with my husband, there was no interpreter. I didn't know what was going on and nobody went back to tell him. He thought I might not be coming back."

"I had an interpreter most appointments, they were good and I could understand everything. The midwife gave me some leaflets in my language which I did not expect but this was good because Google translate is not always accurate."

"I was so scared because they said they couldn't find an interpreter for me but the baby was coming. The doctor was Kurdish, like me. I was so happy and this made me feel safe again."

"I rang triage and they asked me to come in to have a check. It was a long time waiting but everyone was good and kind. I got medicine to help the pain, there was a doctor who spoke Arabic and he talked to me for a while. I wish he had been there when my baby was born."

Many women describe feeling insufficiently involved in decisions about their care, particularly in relation to induction of labour, vaginal examinations and birth choices. Some women report that options are not always clearly explained, and that risks are presented in a way that can feel directive, limiting their sense of choice.

A lack of accessible information and support to understand decisions can reduce confidence and ability to advocate for themselves.

"I had wonderful antenatal care with my first baby and worked with the hospital to create a trauma informed care plan. Unfortunately on the day I went in to labour ... Birth Centre was closed and I couldn't go to ..., so I had to go to labour ward. Nobody read my trauma informed care plan and I suffered more trauma because of this. There were so many little things they could have done to help me and to personalise my care, but they didn't do it. This had a huge impact on me postnatally and I don't know if I'll ever be able to put myself through that again, even though I do want to have more than one child."

"I decided to decline an induction of labour when it was offered to me, but I did not feel that it was presented as a genuine choice. Staff often used language such as 'you will be having an induction', rather than discussing my options with me. After I declined, I received daily phone calls from the hospital for around ten days. It was usually a different person each time, and they seemed to think I was booked in to attend despite me repeatedly explaining that I had chosen not to proceed. The repeated calls felt like harassment. One member of staff told me that 'you can't just refuse' and spoke to me about the risks of shoulder dystocia and stillbirth. I was also told that I would 'have to' attend for daily monitoring. During this time, I felt under pressure to change my decision. However, my community midwife was supportive of my choice and helped me feel listened to and respected."

Across both North and South Kirklees, women describe instances where they felt their concerns were not taken seriously, including not being believed about pain levels or labour progression. These experiences can have a significant impact on trust and overall perceptions of care.

"I felt that my concerns about my pain levels and how my labour was progressing were not taken seriously. I did not feel listened to or believed."

"I went to the triage but they asked me why didn't I ring before I went but I didn't know and it's hard to understand. I was in pain and they left me to wait for a long time. I didn't get any pain relief when I kept asking."

Many women described highly positive experiences of maternity care and spoke warmly about the kindness, professionalism and support provided by staff. Women particularly valued feeling listened to, respected and involved in decisions about their care.

"I had a wonderful experience at ... Birth Centre. The staff were exceptionally kind and attentive throughout my stay. I felt reassured and well cared for both during and after labour. I am grateful to have had such a positive experience."

"I gave birth to my second baby at ... Birth Centre and had a wonderful experience. I arrived at around 6.30am and gave birth in the water by 9am. The whole experience felt calm and relaxed, and we were able to enjoy those precious first few hours with our baby after the birth. One thing that really stood out was that the midwives carried out the Newborn Infant Physical Examination (NIPE) themselves. With my first baby at ..., I remember having to wait a long time for a doctor to complete these checks before we could be discharged. This time, everything was much more straightforward, and we were able to go home later that afternoon. The care I received was excellent, and the whole experience felt efficient, supportive and family-centred. I joked that I could even have done the school run before deciding to go home and enjoy a cup of tea instead. Overall, it was a really positive birth experience."

However, alongside these positive experiences, women described variation in the care and support they received at different points in the maternity pathway. This included:

• Inconsistent support with pain relief and breastfeeding.
• Differences in how birth plans were acknowledged and followed.
• Variation in the involvement of birth partners.
• Differing experiences in relation to safeguarding and culturally sensitive care.
• Inconsistent approaches to supporting informed choice and decision-making.

For some women, this inconsistency created uncertainty, frustration and anxiety, particularly during significant moments of their maternity journey. Women described receiving different messages from different professionals and feeling that their preferences or decisions were not always respected.

Women identify gaps in preparation for certain aspects of care, particularly caesarean births (both planned and unplanned) and induction of labour. This includes limited awareness of options, and in some cases, cultural stigma or lack of open discussion.

Induction of labour is a growing theme in feedback, with women describing a combination of:

• Limited involvement in decision making.
• Perceptions of urgency and risk.
• Delays in the process.

Together, these factors can contribute to heightened anxiety and negative experiences, despite positive feedback about the quality of care provided by staff.

"I felt pressured to accept an induction of labour after polyhydramnios was identified and a scan showed that my baby was measuring large. It was not presented to me as a genuine choice, and I felt as though there were no other options available. During these discussions, I was told that I would be 'allowed' four hours for each stage of labour to progress. When I arrived for my induction, the unit was very busy. My contractions started and progressed quickly, but I was given an injection to slow them down because there was no bed available on the labour ward. I remained in this situation for around 12 hours before being moved, by which time I was exhausted, stressed and anxious about what was happening."

Women speak positively about birth centres and home birth options, but there is sometimes limited awareness of these choices or uncertainty about eligibility. Increasing awareness and accessibility of these options remains an area for development.

Taken together, this feedback highlights a system where high-quality, compassionate care is frequently delivered, but where inequalities in access, communication and involvement in decision making persist.

Women consistently value being listened to, respected and involved in their care. Where this is achieved, experiences are positive. Where it is not, trust can be undermined.

Strengthening consistent communication, improving access to information, and ensuring that all women, particularly those facing the greatest barriers, are able to understand their choices and have their voices heard, will be critical to improving outcomes and reducing inequalities in maternity care in Kirklees.

"I gave birth to my fourth baby at the ... Birth Centre around two and a half months ago and had a lovely experience. The midwives were calm, supportive and made me feel really comfortable. I had not originally planned to give birth at the birth centre, but when I arrived, I was offered the option because my pregnancy had been uncomplicated. I felt encouraged to make the choice that was right for me and was supported throughout. I felt in control of my birth and it turned out to be the best birth experience I have had."

Some women report that postnatal care, particularly within primary care, does not always meet their needs. Feedback includes concerns about limited physical checks and a perceived "tick-box" approach to mental health conversations.

"I was not offered a birth debrief after having my baby, and I felt that my emotional recovery was largely overlooked. I would have valued the opportunity to talk through my birth experience and ask questions about what happened. I also found it difficult to access follow-up support, including wound care when I needed it. Overall, I felt that the focus was on my physical recovery immediately after birth, with less attention given to my emotional wellbeing and ongoing support needs."