How maternity experiences shape policy and practice: insights from the 2025 Maternity Survey
Experiences of pregnancy, labour and birth, and the weeks that follow often stay in people’s memories long beyond the clinical outcomes. Maternity care encompasses a wide range of healthcare services delivered by various healthcare professionals across multiple settings. It is therefore not surprising that maternity care is one of the most complex and policy-intensive areas of the NHS in England, shaped not only by national strategies but ongoing learnings from high-profile investigations and inquiries into poor performance. These policies seek to improve safety and equity through service user empowerment and preventative care¹.
The 2025 Maternity Survey provided an important opportunity to understand the lived experiences of people using maternity services in England. Drawing on responses from around 17,000 service users, the survey offers a valuable insight into where national strategy is beginning to translate into everyday care and where gaps between policy intent and lived experience remain.
Experience data, used in combination with other data sources, plays a crucial role in monitoring, regulating and improving maternity services and helps to identify where care is working well, where it is inconsistent, and where further attention is needed to drive improvement .
Signs of improvement: communication, involvement and mental health support
One of the most consistent outcomes from the 2025 survey is improvement in experiences of communication during pregnancy. Nearly nine in ten respondents reported being spoken to ‘in a way they could understand’, continuing a statistically significant upward trend over the past five years. More respondents also said they were given enough time to ask questions and that they felt midwives listened to them during antenatal appointments.
These findings are important because communication is at the centre of national policy, which emphasises person centred care and personalised support as the core aims of NHS reform. Effective communication is linked to safety and trust, and it enhances people using maternity services’ ability to feel listened to, taken seriously and to be involved in decision-making. Moreover, evidence suggests when people feel heard, they are more likely to raise concerns, discuss symptoms and seek help when they need it – these are fundamental to safer care².
This emphasis on communication is also evident in relation to perinatal mental health. Compared with earlier surveys, more respondents reported being offered mental health support during pregnancy and being told who to contact if they needed help after birth, suggesting that national efforts to strengthen perinatal mental health provision are beginning to be felt in some areas of maternity care. However, these improvements are not yet reflected consistently across the maternity journey, as when asked about being offered information about changes in their mental health after birth, only around three out of five respondents reported positive experiences.
Taken together, these findings suggest that long-standing policy commitments to more personalised care and involvement in decision-making are starting to be felt in people’s experiences of maternity care.
Variation between national policy and lived experience
While the 2025 survey results point to continued improvement in some areas, they also highlight aspects of maternity care where experiences fall short: including continuity of carer, concerns being taken seriously, and experiences of using Maternity Triage.
Evidence shows that continuity of carer is not only associated with better experiences³ but is a significant factor in improving maternal and neonatal clinical outcomes, particularly for people with social risk factors such as poverty, people from ethnic minority groups, younger mothers, refugees, and those living with mental health issues⁴. Continuity of carer is a core maternity policy priority in England, which aims to build trusting, ongoing relationships between people using maternity services and their carer throughout pregnancy⁵. The 2025 survey reinforces this: survey respondents who experienced greater continuity were consistently more likely to report positive experiences across antenatal, labour and birth, and postnatal care. However, many reported having the same midwife only ‘some of the time’, or ‘not at all’. These respondents were more likely to report poorer experiences, particularly in relation to feeling listened to and supported.
Delivering continuity of carer at scale remains challenging, particularly in the context of ongoing workforce pressures. While these constraints affect the extent to which continuity of carer models can be implemented consistently, the survey findings underline that continuity of carer remains a central component of people’s maternity experiences, with clear links to perceptions of safety and quality of care⁶.
Although involvement in decision-making during labour and birth shows a small improvement compared with 2024, the 2025 survey results show that a notable minority of one in five respondents did not feel their concerns were consistently taken seriously or reported being left alone at time when they were worried about themselves or their baby.
The introduction of a new set of questions on Maternity Triage in 2025 offers additional insight into early points of contact with maternity services. While around seven in ten respondents reported receiving the advice they needed when contacting telephone triage services, a notable proportion (21%) indicated that this was only ‘to some extent’. Given that triage is often the first point at which people seek urgent advice, variation in experience at this stage remains important, particularly as national guidance and safety reviews emphasise the need for timely assessment, clear communication and consistent decision-making in these settings⁷.
Variation in experience across different groups
The maternity survey provides important insight into how experiences vary across different groups. These include demographic factors such as age, ethnicity, religion, sexual orientation and whether gender is the same as sex assigned at birth; social factors such as deprivation and whether English is their first language; clinical factors such as parity, type of delivery, long-term health conditions and pregnancy-related conditions; and continuity of care during antenatal and postnatal care.
The 2025 findings indicate that respondents were more likely to report poorer experiences if they were younger, giving birth for the first time, living in more deprived areas, or if they did not experience continuity of care. People with long-term mental health conditions and certain pregnancy-related health conditions also reported less positive experiences in specific areas of care, such as pain management and involvement in decisions.
These patterns are consistent with wider evidence on inequalities in maternity care. National confidential enquiries have repeatedly shown that people living in more deprived areas, and those from some ethnic minority backgrounds, have consistently poorer outcomes⁸. Experience data from the 2025 survey complements this evidence by showing how such inequalities are reflected in everyday interactions with maternity services, including whether people feel respected, listened to and supported.
From national findings to local improvement
The 2025 national level data provides valuable insight into how maternity care is experienced across England. However, its practical impact depends on how trusts and maternity services use the data at a local level to inform improvement.
Many trusts publish their maternity survey results and communicate how the findings are used locally. In some cases, this includes describing how survey feedback is considered alongside input from local Maternity and Neonatal Voices Partnerships (MNVP) to inform priorities for improvement, or highlighting areas where results indicate progress. Other trusts incorporate the survey findings into their performance reporting, reinforcing the role of maternity survey experience data in actively shaping local quality improvement.
The value of the survey lies not only in identifying areas of concern, but also in showing where change could be possible. Improvements over time in areas such as communication, involvement in decisions and mental health support suggest that focused national strategy combined with local action, can shape better maternity care experiences. Where results are static or poor, the findings help to highlight areas where implementing change may be constrained, providing a basis for further examination of the factors limiting progress.
What experience data adds to maternity policy and practice
The 2025 Maternity survey reinforces the importance of experience data in understanding how maternity policy is translated into care. The findings show that progress is evident is some areas, while longstanding challenges remain in others. People’s experiences provide critical insight not only into how care is delivered on the ground, but also into where national strategy is beginning to be realised and where further attention may be needed.
Alongside clinical data, experience data offers an important perspective on how maternity services work in everyday settings and help to amplify patient voice. As national policy continues to evolve, experience survey data will remain essential in ensuring that change is not only designed at a national level, but that it is designed with an understanding of how services are experienced locally and whether people using maternity services feel that services are improving.
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