Some maternity units have high rates of birth complications, suggesting a need to review their standards, according to the findings of a major audit published today.
Researchers said that maternity care safety continues to improve – but that variations exist.
The researchers from the National Maternity and Perinatal Audit say that other factors may explain the variations, including data quality and the proportion of high risk women in different units.
According to the analysis, 2.5% of women suffer major obstetric haemorrhage – but in some units the rate reaches 5%.
Similarly, some units had twice the national rate of obstetric anal sphincter injuries, which overall affect one in 30 vaginal births.
There are also variations in breastfeeding rates and in the proportion of babies achieving skin to skin contact with the mother within an hour of birth. Overall this happens in 80% of births, the study found.
The auditors found that in some units one in 30 babies have low Apgar scores – while nationally this applies to one in 80 neonates.
The investigation covers England, Scotland and Wales – and shows that a 15.7%, Wales has the lowest rate of caesarean sections.
Professor Jan van der Meulen, of the London School of Hygiene & Tropical Medicine, leader of the project, said: “In some hospitals, the quality of the clinical data needs to be further improved so that the audit can provide an accurate picture of the care that they provide. The audit’s results will be a great help to improve the quality of maternity services.”
National clinical director for maternity review Dr Matthew Jolly said: “The report confirms that, despite the increasing numbers of complex births, the vast majority of women receive high quality care and deliver healthy babies.”
Professor Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists, added: “Some variation is expected and can drive new improvements, but unwarranted or unexplained variation requires investigation.
“We urge all maternity units to examine their own results and those of their neighbours both to identify role models and to drive quality improvement locally.”
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