How Royal Surrey cut induction complaints by 90% and tripled uptake of antenatal education

Summary

Uptake of antenatal education up 200%
Formal and informal induction of labour complaints down 90%

Midwives freed from 4 to 5 hours a day of booking admin

Paid for through NHS digital innovation funding, after the trust first said no

Over £20k a year in booking fees saved, with income now kept in maternity

Royal Surrey's content can be shared with other trusts

For years, Kate Conway started her working day on an apology round.

As antenatal matron at Royal Surrey NHS Foundation Trust, she would walk the ward talking to women waiting for induction of labour. Why it was taking so long. Why they were tired. Why they were in pain. What was likely to happen next.

She hasn't had to do that for over 18 months.

Kate also leads the trust's Birth and Beyond antenatal education service. At our recent webinar on improving maternity outcomes through personalised education, she explained how giving every woman one trusted place to find information changed complaints, midwife workload and class uptake.

Parents were learning about birth from TikTok

Kate opened with a question for the audience: where are your women getting their information from?

At Royal Surrey, the honest answer was not from the trust. It was TikTok, Instagram, Facebook, Google and, more recently, ChatGPT. Influencers were telling women what the perfect birth looked like and which interventions to refuse. One claim Kate heard: that oxytocin would cause autism.

The trust's own offer wasn't competing. Classes were run by community midwives on rotation, with no set lesson plans and no consistency. Some midwives loved it, some hated it. Classes took place in GP surgeries with, in Kate's words, a "broken biscuit, NHS cup of tea".

During COVID, the team moved everything to Facebook due date groups over a single weekend. It worked at the time. Afterwards, women no longer wanted it. They didn't feel it was secure, and they wanted contact with staff.

The practical problems stacked up too. Bookings ran through Eventbrite. Women who didn't use Facebook missed out. The trust serves women who speak many languages, including Polish, Ukrainian, Dari, Portuguese and Bengali. Some women couldn't read. Neurodivergent women and women with learning disabilities had few suitable resources.

And women wanted more than a leaflet. They wanted to look up induction of labour on their phone on the way out of an appointment.

What they built

After listening to events with the Maternity Voices Partnership, midwives, obstetricians, sonographers and support workers, the team designed a parent portal: a secure website each woman logs into from her phone. It went live in October 2024.

Every woman gets a login at booking. When she opens it, she sees what matters for her stage of pregnancy: upcoming appointments, scans, vaccinations, public health messages and what to read next. As her pregnancy moves on, so does what she sees. She can also read the same guidelines and policies staff work from, so she understands why she's being offered something.

Alongside this sits a library covering pregnancy and the months after birth, including:

An induction of labour toolkit with five three-minute videos, a birth plan template, relaxation audios and positive induction stories

Toolkits for caesarean birth and recovery, and for postnatal discharge

A pregnancy relaxation and hypnobirthing course developed with a cognitive hypnotherapist

Parent mental health resources, with guides for partners too

Walking tours of the maternity unit, which have particularly helped neurodivergent women

Women can read every page in over 200 languages, and it works with the screen readers blind and partially sighted women already use. Anyone without a smartphone or data can be given one through a partnership with the Good Things Foundation.

Women also book, pay for and cancel places on all 19 classes, free and paid, in the same place.

Because the midwives write and update the content themselves, they can react fast. The team runs "What have you googled this week?" polls on social media. If women are searching for something that isn't covered, a new page can usually be live within 24 hours.

Early feedback from a Polish service user summed up what the team wanted: "Reading all the information in my own language was very helpful and I felt that I was important too, even if English wasn't my first language."

Uptake of antenatal education up 200%

Since launch, uptake of antenatal education has increased by 200%. As of March 2026:

5,800 registered users

Over 22,500 visits to the library

14,000 class bookings

74% of women say they use the portal regularly

79% say it encouraged them to book classes

73% say they felt better prepared for birth and early parenthood

Women who regularly use the portal or attend a class are also less likely to need the trust's birth reflection service.

One woman had planned a caesarean. After her midwife and consultant pointed her to the induction toolkit, she watched the videos, did the relaxation work and decided to try induction. "I had a vaginal birth," she said. "It was really hard, but it was totally epic."

Induction complaints down 90%

Formal and informal complaints about induction of labour have dropped by 90%. That is why Kate's apology rounds stopped.

Midwives now ask women on admission whether they've read the toolkit, and suggest watching the videos while they are on the CTG. QR code posters around the unit link straight to the content. The same approach at postnatal discharge covers safe sleep, bathing and feeding. Less time repeating the same explanations means more time for care.

The effects reach beyond education. The vaccination clinic is full every day because women get a reminder at the right time. More women now use home blood pressure and glucose monitoring, helped by the work on digital exclusion. Kate credits the portal as contributing to the trust's CQC outstanding rating, its Baby Friendly gold reaccreditation and top results in the CQC maternity survey. The project also won an HSJ award.

Money that used to go to Eventbrite now goes back into care

Before the portal, antenatal education midwives spent four to five hours a day managing bookings and checking class lists. That time now goes to women.

Women manage their own bookings and payments, and can pay in instal ments . So if a woman chooses a paid class, it's because she wants that format, not because money decides for her. Every woman gets the same content from the same midwives, free or paid. The only difference is where and how it's delivered.

Paid classes also fund the free offer. The trust's complete course, run in small local groups so couples can build friendships the way they might through private providers. That income pays for free walks with midwives, coffee mornings, relaxation classes and birth workshops open to every woman booked with the trust.

Small things got easier too. A woman whose waters have broken is asked to monitor her temperature at home. If she doesn't have a thermometer, triage can give her one there and then, paid by QR code, rather than sending her to the supermarket. The same goes for colostrum collection kits and TENS machine rental. Scan payments in antenatal clinic now work the same way.

The trust used to pay over £20,000 a year in Eventbrite fees, and many payments could only be taken in cash. Last financial year , payments through the portal brought £109,500 into the trust, with a further £50,000 from scan payments since they went live a year ago. That money now stays in maternity, supporting classes and the portal's development.

What it didn't change

Kate was clear about the limits. The toolkits haven't reduced maternal request caesareans, and they were never designed to. Most women arrive having already made that decision. The aim is to help women make evidence-based choices and feel prepared, including for caesarean recovery.

How they funded it when the trust said no

When Kate first costed the portal, the trust said no.

So she bid to digital innovation funds, three times. The third bid, to NHS Digital, was successful. The case rested on three points: the security and confidentiality risks of using Eventbrite and Facebook, the admin burden on midwives, and the need to widen access to education for all women.

Today, the portal is partly funded by what it brings in, with support from the trust charity and the chief executive. Phase two is under way: a mobile app due by the end of the year, with phone reminders, mental health journaling and a care calculator that points women to the right care pathway based on their own risk factors.

Keeping it running takes little effort. A small team of antenatal education midwives, digital midwives and clinical governance look after it, and updates take minutes.

If you're thinking about the same for your trust

You wouldn't be starting from scratch . Royal Surrey built its portal with VerseOne , and its content can be transferred to other trusts. Most of it draws on NHS, NICE and RCOG sources. For the toolkits, Royal Surrey can share a guide to what's in them so you can build your own.

Several trusts are already working towards their own portal this way, and some have used Royal Surrey's funding case as a starting point for theirs.

The takeaway

Women will look for information whether you give it to them or not. Royal Surrey chose to become the source they trust, in their language, on their phone, at the moment they need it. The result is better-prepared parents, fewer complaints and more midwife time for care, in a service that now funds more of its own development.

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