Thousands of women are being left alone and frightened during labour, a survey has suggested.
The poll of nearly 3,000 mothers also found many complained about the noise and lack of privacy and cleanliness in post-natal wards.
But overall women were satisfied with their care and four out of five said staff were supportive, the National Perinatal Epidemiology Unit found.
It comes as the Healthcare Commission watchdog launches a review of services.
"Care can undoubtedly improve, too many women are being left on their own"
More than half of women said they were left alone during labour, with one in five of these reporting it caused them to worry.
The study, commissioned by the Department of Health and the Healthcare Commission, also said some women complained that staff could be bossy and unhelpful.
Many women were also unhappy with their post-natal care. Some 28% were critical about the lack of privacy, 22% about space, 19% cleanliness and 23% noise.
There was also a low level of choice offered to women about where they could give birth.
Just 38% of women were given an option of a home birth - double the number in 1995 but well short of the government's pledge to give all women a choice of where to give birth by 2009.
However, on other aspects of care for the women surveyed, 97% of whom gave birth in a hospital or birth centre, the results were more positive.
Some 98% of first-time mothers reported being offered NHS antenatal classes but only two-thirds attended them.
Almost all women felt they were treated with respect and kindness during their initial antenatal booking appointment.
Positive
During labour, perceptions of doctors and midwives were also generally positive, although there were still variations in the way care was provided for, and experienced by, different groups of women, in particular ethnic minority women.
Despite some of the communication concerns, 93% of women said doctors spoke to them in a way they understood compared with 66% in 1995.
And four out of five women said staff were supportive during and after birth.
Sally Russell, director of the Netmums support group, said the results of the survey mirrored many of the experiences of her organisation's members.
She said: "Care can undoubtedly improve. Too many women are being left on their own.
"Our impression is that there is a lack of midwives which is exacerbating the problem."
The Royal College of Midwives estimates the profession needs another 10,000 midwives in the coming years.
Healthcare Commission chief executive Anna Walker said there were some areas where there was "room for improvement" and announced the watchdog would be launching a review of maternity services.
The Healthcare Commission will interview over 50,000 women who gave birth during February in the largest survey of its kind.
Gwyneth Lewis, the government's National Clinical Lead for Maternity Services, said: "The findings from this survey are feeding into the soon-to-be-published maternity delivery plan.
"That will set out how we will achieve services that provide real choice and support for women in all settings, from antenatal care through to the early child years."
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