Variation in maternity services and stillbirths across the UK
- 02.11.2016
- GillEdwards
- Clinical-negligence, Opinion, Clinical-negligence, Opinion
If you knew that your chance of suffering a stillbirth or losing a baby in the neonatal period was seven times greater in some areas of the country than others, you would want to know why wouldn’t you?
And if you knew that 75% of maternity services were classed as “needing improvement” you’d be concerned. NHS England has just published new ratings on maternity services which confirm these statistics.
The chance of having a stillbirth or neonatal death is low but there is a huge variance in standards of care and outcomes for women and babies across the country; in Windsor, the chance of a stillbirth or neonatal death is 1.8 per 1000 births whereas in Blackburn in Lancashire or Dewsbury in Yorkshire, it is 13 per 1000.
There will undoubtedly be socio-economic factors at play but shouldn’t the difference in outcome be less than this in the 21st century given that we are all entitled to expect the same standard of care?
The maternity ratings are based not only on the stillbirth and neonatal death rates, but also on maternal smoking, women’s reported experience of maternity services and choices in services.
The Royal College of Midwives has expressed concern and encouraged those providing poorly performing services to address the variation urgently. They rightly point out that providers should learn from each other but services are also under resourced because of funding cut backs.
Trusts need to share information and training about good and bad practice to improve standards countrywide. The idea behind empowering patients to choose where to have their babies is well-meaning but it is not a real choice that most people are free to take.