The more things change

The main messages from the survey were that maternity care varied widely from one district to another and often varied within communities and within hospitals. Much depended on both the attitudes and preferences of the individual providing care and whether a woman was offered care as part of an innovative pilots project. In a number of areas, Changing Childbirth pilots were closed down rather than rolled out across the district, despite good results. Evidence of more woman-centred care suggests that attitudes towards women had changed more than the actual services. However, those women who were interested in a home birth were still experiencing major obstacles. Postnatal care and support for breastfeeding were identified as those aspects of care most in need of improvement.