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Almost 30% of women said they were not given advice during antenatal visits about healthy weight gain, and about one in 10 said they were not told about the risks of alcohol consumption or exposure to tobacco smoke. Responses from women who gave birth in southern NSW were significantly more positive than the overall state results. At a hospital level, responses were most positive for Ryde hospital in Sydney and Wyong hospital on the central coast. Responses were least positive for Fairfield in western Sydney. The chief executive of the Bureau of Health Information, Dr Jean-Frederic Levesque, said the survey was conducted to establish whether the maternity care received by women in public hospitals was in line with their expectations so that hospitals could improve. We wanted to give women a voice and to see how engaged they felt with their own care, he said. While some of the more poorly rated hospitals saw higher proportions of women from diverse cultural backgrounds, including women who spoke English as a second language, as well as higher proportions of women from lower socioeconomic areas, others with a similar demographic of patients, such as Ryde, performed exceptionally well. What we see is that there are hospitals providing excellent care to women regardless of their cultural background or socioeconomic status, Levesque said. But the head of the Australian Medical Association, obstetrician Dr Michael Gannon, said there might be some bias in the survey towards women with English as a first language because they would have been more likely to have responded to the survey. But he said it was a nonetheless a strong survey that highlighted the importance of continuity of care, with those hospitals offering such care rated more highly across all categories, including postnatal care. Whether that continuity comes from having the same obstetrician or the same midwife, it is extremely important to women and it makes them feel safer and more comfortable, Gannon said.