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Concerning figures revealed in maternity units across UK

Maternity units have been urged to investigate after figures revealed differences in care for mothers and babies across Britain.

Maternity units have been urged to investigate after figures revealed differences in care for mothers and babies across Britain.


Royal College of midwives has said it is vital midwives provide support to expectant mothers. Picture: iStock
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Findings of the National Maternity and Perinatal Audit (NMPA), the largest of its kind in the world, show the vast majority of women in England, Wales and Scotland have a safe birth.

But the number of babies requiring additional support and mothers experiencing adverse outcomes such as bleeding and severe tears differ across services.

The Royal College of Obstetricians and Gynaecologists (RCOG) said while some disparity in care is expected, 'unwarranted or unexplained' differences should be investigated.

Meanwhile, the Royal College of Midwives (RCM) has expressed concern about the number of overweight mothers and the proportion of pregnant women who smoke.

Data figures

The data, which covered 696,738 births between April 2015 and March 2016, showed 3.5% of women sustained third or fourth degree perineal tears during vaginal births.

But this figure ranged from 0.6% to 6.5% across maternity services.

While hospitals reported 1.2% of babies in the UK required additional support in the minutes after they were born, some units recorded figures as low as 0.3% and others as high as 3.5%.

In England and Wales, 2.7% of women giving birth experienced a major haemorrhage. This figure ranged from 1.1% to 5.6% of women across services in the two countries.

Variation across the UK

RCOG president Lesley Regan said: 'While the UK is a safe place for women giving birth, this report shows variation in care and outcomes for women and babies in maternity services in the UK.

'Some variation is expected and can drive new improvements, but unwarranted or unexplained variation requires investigation.'

'Vital midwives provide support'

RCM chief executive Gill Walton said the level of maternal obesity was 'most worrying' with fewer than half of pregnant women having a body mass index in normal range (18.5 to 24.9 for most adults).

'Being obese when pregnant can cause complications for women and their babies. It is vital that midwives have enough time to give advice and support, as well as access to specialist services that they can refer the woman in a timely manner,' she said.

Ms Walton added: 'There is also extremely wide variation in the proportion of women who gave up smoking during pregnancy not only in England, but right across the UK. The levels of those smoking during pregnancy remains high, so it is clear that much more work needs to be done to support women with smoking cessation.'

The data, which was collected from 149 of 155 NHS trusts and boards providing care in England, Wales and Scotland, covered approximately 92% of births during the period.

The audit noted that some variations can be attributed to differences in data quality, completeness and the risk profile of women in different units.

The NMPA was commissioned by the Healthcare Quality Improvement Partnership on behalf of NHS England, the Welsh government and the Health Department of the Scottish government.

It is a collaboration between RCOG, the RCM, the Royal College of Paediatrics and Child Health and the London School of Health and Tropical Medicine.

Read the full audit results


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