Reid Holly E, Smith Debbie M, Widdows Kate, Heazell Alexander Ep
Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
BMJ Qual Saf. 2025 Sep 2. doi: 10.1136/bmjqs-2025-018582.
In 2019, NHS England launched the second version of the Saving Babies' Lives Care Bundle (SBLCBv2), recommendations that maternity providers are expected to fully implement, in an ongoing effort to reduce stillbirths and preterm births. Although stillbirth rates have seen an overall significant reduction since the inception of the SBLCB, experiences of maternity care in England are deteriorating. This study aimed to explore service users' experiences of SBLCBv2-informed maternity care to help understand the aspects of care they received positively and those needing improvement.
This qualitative study captured service users' experiences of receiving maternity care across England between November 2022 and December 2023. Purposive sampling was employed to include service users from diverse backgrounds with a variety of experiences of each element of SBLCBv2. Participants (n=29) were 16 years or older, had given birth within the previous 12 months and could comprehend and speak English. Semi-structured interviews were conducted via video call and the data analysed using reflexive thematic analysis.
Four main themes with nine subthemes were developed: (1) feelings towards measuring and monitoring, (2) the importance of clear communication, (3) healthcare professionals' roles in decision-making and (4) belief in service users, trust in healthcare professionals. Each theme is discussed in relation to the five elements, and the 'Important Principles', of SBLCBv2.
Our findings echo maternity care needs reported elsewhere in the literature, suggesting the interventions introduced in SBLCBv2 are generally acceptable but that information about SBLCBv2 must be personalised, and clearly presented, to each individual. Professionals play an important role in service users' decision-making, and participants' perceptions of how collaborative and supportive professionals were in decision-making processes varied. Believing service users and trusting professionals are of paramount importance for ensuring service users have positive maternity care experiences.
2019年，英国国民保健制度（NHS）推出了第二版拯救婴儿生命护理包（SBLCBv2），这是一系列建议，产科服务提供者应全面实施，以持续努力减少死产和早产。尽管自SBLCB推出以来，死产率总体上有了显著下降，但英国的产科护理体验却在恶化。本研究旨在探讨服务使用者对基于SBLCBv2的产科护理的体验，以帮助了解他们得到积极护理的方面以及需要改进的方面。
这项定性研究记录了2022年11月至2023年12月期间英国各地服务使用者接受产科护理的体验。采用目的抽样法，纳入来自不同背景、对SBLCBv2各要素有不同体验的服务使用者。参与者（n = 29）年龄在16岁及以上，在过去12个月内分娩，能够理解和说英语。通过视频通话进行半结构化访谈，并使用反思性主题分析法对数据进行分析。
形成了四个主要主题和九个子主题：（1）对测量和监测的感受，（2）清晰沟通的重要性，（3）医疗保健专业人员在决策中的作用，（4）对服务使用者的信任、对医疗保健专业人员的信任。每个主题都结合SBLCBv2的五个要素和“重要原则”进行了讨论。
我们的研究结果与文献中其他地方报道的产科护理需求相呼应，表明SBLCBv2中引入的干预措施总体上是可以接受的，但关于SBLCBv2的信息必须针对每个个体进行个性化且清晰的呈现。专业人员在服务使用者的决策中起着重要作用，参与者对专业人员在决策过程中的协作和支持程度的看法各不相同。相信服务使用者并信任专业人员对于确保服务使用者有积极的产科护理体验至关重要。
