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Babies Born Better

Around the globe, the improvement of maternity care is one of the pending issues to increase the wellbeing of women, families and whole communities
. To inform a lasting and meaningful progress, it is essential to collect and compare data about service design, health indicators and outcomes on a local, regional and international level. With this aim, a number of national and multinational organisations already collect predominantly quantifiable information (for example Destatis and QUAG in Germany, ONS and HSCIC in the UK, Euro Peristat in Europe and the WHO worldwide1). Based on this data, a strong regional variance in the design of care, levels of intervention and clinical outcomes can be observed. It has been suggested that this variance stemmed from differences in political, legal, economic and cultural differences. However, this does not justify the magnitude of variance, particularly of intervention rates and clinical outcomes. Visibly, the translation of evidence to practice encounters severe barriers, which renders these differences even less acceptable. Yet, without further investigation, it is difficult to interpret the large amount of quantitative data, which is currently being collected in the European Union and elsewhere.

In the attempt to approximate maternity services in different regions in a mutual pursuit of quality and equity in healthcare, it is vital to gain a deeper understanding of the care experience of women and families. A number of governments and international agencies already embraced a patient-centred orientation and added client satisfaction to the core indicators of quality care. Today, care satisfaction has advanced to the most frequently used salutogenically oriented outcome measure. However, opposed to quantitative data collection, the investigation of user views is often limited to a local or regional level. Few organisations investigate the quality of the care experience on a national level (for example the Gesundheitsmonitor in Germany and the CQC and NPEU in the UK1). A multinational and multifaceted investigation of experiences of maternity care was not attempted before.

The Babies Born Better (B3) Project aims to fill this gap. In three interrelated studies, the project aims to explore, which topics are particularly important to women, their families and carers in different cultural and regional contexts, what works well and how excellent service strategies can be transferred to other settings. Thereby the B3 Project aims to supplement quantitative data and provide guidance for the improvement of maternity services in Europe, and worldwide.

The currently most advanced and active part of the B3 Project is the B3 User Survey. The study was designed to explore women’s experiences of maternity care. It is currently live in more than 20 languages, and represented in more than 30 countries.


1) Abbreviations and full names:

Destatis = Statistisches Bundesamt (Germany)

QUAG = Gesellschaft für Qualität in der außerklinischen Geburtshilfe e.V. (Germany)

ONS = Office for National Statistics (UK)

HSCIC = Health and Social Care Information Centre (UK)

WHO = World Health Organization

CQC = Care Quality Commission (UK)

NPEU = National Perinatal Epidemiology Unit (UK)



Marina Weckend:

Prof. Mechthild Gross:

Publications and Conference Presentations


Weckend MJ Downe S Balaam M-C Lengler L Gross MM. Das Babies Born Better Project: Europäische Umfrage zur Erfahrung mit der Gesundheitsversorgung in der Schwangerschaft, während des Gebärens und im Wochenbett. Deutscher Hebammenkongress, 03.05.2016, Hamburg, Germany.


Weckend MJ Downe S Balaam MC Lengler L deWall S Gehling H Grylka-Baeschlin S Gross MM. Gesundheitsversorgung und Geburtshilfe im Umbruch: Was berichten Frauen über Defizite und Potenziale in Deutschland? - Die Babies Born Better User Survey [Health and maternity care in transition: What do women report about deficiencies and potential in Germany? - the Babies Born Better User Survey]. Z Hebammenwiss [J Midwifery Sci]. 2016;04(Suppl.1):34-35; doi:10.3205/16dghwi18 [Poster]


Weckend MJ Gross MM Update on the Babies Born Better Project. Conference of the COST Action IS0709, 05.10.2015, Lancaster, UK.


Gross MM Weckend M. Preliminary cross-country analysis and country specific analysis. Contribution to symposium: The Babies Born Better Survey. 10th Normal Labour and Birth Conference, 15.-17.06.2015, Grange over Sands, UK.


Weckend MJ Gross MM. The Babies Born Better Project. Conference of the COST Action IS0709, 05.05.2015, Barcelona, Spain.


Weckend M. Women's experiences of maternity care in Germany and Austria: The Babies Born Better User Survey. MSc Thesis. 2015. University of Central Lancashire, Preston, UK.