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An Evaluation of Maternity Care Provided in Three Sure Start Local Programmes in Islington

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An Evaluation of Maternity Care Provided in Three Sure Start Local Programmes in Islington City Research Online City, University of London Institutional Repository Citation: Twamley, K., Irvine, P., Procter, S. and Macfarlane, A. J. (2006). An evaluation of maternity care provided in three Sure Start Local Programmes in Islington. Final report. London, UK: City University London. This is the published version of the paper. This version of the publication may differ from the final published version. Permanent repository link: https://openaccess.city.ac.uk/id/eprint/17259/ Link to published version: Copyright: City Research Online aims to make research outputs of City, University of London available to a wider audience. Copyright and Moral Rights remain with the author(s) and/or copyright holders. URLs from City Research Online may be freely distributed and linked to. Reuse: Copies of full items can be used for personal research or study, educational, or not-for-profit purposes without prior permission or charge. Provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. City Research Online: http://openaccess.city.ac.uk/ [email protected] An evaluation of maternity care provided in three Sure Start Local Programmes in Islington Final Report September 2006 Katherine Twamley Penelope Irvine Susan Procter Alison Macfarlane St Bartholomew School of Nursing and Midwifery, Institute of Health Sciences, City University 24 Chiswell Street, London EC1Y 4TY Published in 2006 by City University Northampton Square London EC1V 0HB © 2006 All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronically or mechanically, including photocopying, recording or any information storage or retrieval system, without either prior written permission in writing from the publisher or a license permitting restricted copying. In the United Kingdom such licenses are issued by the Copyright Licensing Agency: 90 Tottenham Court Road, London W1P 0LP. British Library Cataloguing in Publication Data A catalogue record for this report is available from the British Library. ISBN 978-1-900804-01-1NTR Research Team Susan Procter, Alison Macfarlane, Katherine Twamley, Penelope Irvine, Susan Richards, Lisa Hilder and Ros Bryar Steering Group Mike Sherriff, Director of Islington Sure Start Rachel Ambler, Consultant Midwife Whittington Hospital Fiona Horigan, Programme Manager Sure Start Holloway Joelle Leader, Programme Manager Sure Start Copenhagen Sam Page, Health Visitor Islington Primary Care Trust Jenny Rathbone, Programme Manager Sure Start Hillmarton Acknowledgements Our thanks go first to the women who took part in this study and shared with us their experiences of being pregnant and giving birth in the Islington area. We are also grateful to the many professionals working with and in Islington Sure Start services who related to us their experiences of delivering maternity care and aided us in our collection of data. We would also like to thank all the individuals who provided data for quantitative analysis, with special thanks to Liz Whitehurst from the Whittington Hospital, Ian Wright from Islington Sure Start Unit, Katrin Karlsdottir from Sure Start Holloway, and Lea Sookhoo from the Islington Primary Care Trust. Project funded by Sure Start Islington. Table of Contents Chapter 1: Introduction ..............................................................................................1 1.0 Description of Context........................................................................................1 1.1 Holloway.............................................................................................................3 1.2 Hillmarton...........................................................................................................6 1.3 Copenhagen.........................................................................................................6 Chapter 2: Aims and objectives..................................................................................8 Chapter 3: Methods ...................................................................................................11 3.1 Quantitative Methods.........................................................................................13 3.1.1 Data sources ...............................................................................................13 3.1.2 Analysis.......................................................................................................16 3.1.3 Limitations ..................................................................................................18 3.2 Qualitative Methods...........................................................................................20 3.2.1 Professionals...............................................................................................20 3.2.2 Service Users .............................................................................................21 3.2.3 Data Collection and Analysis .....................................................................23 3.2.4 Limitations and Issues in data collection....................................................23 Chapter 4: Findings for Sure Start Targets ............................................................25 4.1 Smoking during pregnancy................................................................................25 4.2 Breastfeeding ....................................................................................................35 4.3 Mental Health....................................................................................................47 4.4 Access to and provision of antenatal care.........................................................51 4.5 Low birthweight babies.....................................................................................58 4.6 Delivery methods and complications at birth ...................................................61 4.7 Summary............................................................................................................66 Chapter 5: Qualitative findings on users’ experiences...........................................69 5.0 Introduction.......................................................................................................69 5.1 Sure Start engagement and satisfaction ............................................................70 5.2 Disadvantaged Groups......................................................................................86 5.3 Groups with Special Needs...............................................................................89 5.4 Summary...........................................................................................................90 Chapter 6: Staff experiences of delivering services ...............................................92 6.0 Introduction.......................................................................................................92 6.1 Communication between staff ..........................................................................92 6.2 Recruitment Difficulties in Hillmarton.............................................................97 6.3 Job Satisfaction/Retention ..............................................................................100 6.4 Staff experiences of data collection ................................................................104 6.5 Summary.........................................................................................................107 Chapter 7: Bringing the findings together.............................................................108 7.1 Conclusion .......................................................................................................110 7.2 Key Recommendations ...................................................................................111 7.2.1 Sure Start Targets .....................................................................................111 7.2.2 Organisational Recommendations............................................................112 7.2.3 Data Recommendations ............................................................................113 Appendices................................................................................................................115 Appendix 1: City proposal.....................................................................................115 Appendix 2: Data Sources for Quantitative Analysis............................................124 Appendix 3: Sample Information pack for recruitment of service users...............133 i Appendix 4: Qualitative Interview Schedules .......................................................138 Appendix 5: Table of service users recruited for qualitative interviews ...............146 References.................................................................................................................151 List of Figures............................................................................................................. iii List of Tables .............................................................................................................. iii Chapter 1: Introduction ..............................................................................................1 1.0 Description of Context........................................................................................1 1.1 Holloway.............................................................................................................3
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