Advising with empathy and experience

Worrying variations in maternity care.

THE variations in care women receive when giving birth in English hospitals in England is worrying, experts say.

The warning from the Royal College of Obstetricians and Gynaecologists' follows a review of more than 550,000 births which found "substantial variation" in practice between maternity units, and said this may suggest not all women get the best possible care.

The review - carried out with the London School of Hygiene and Tropical Medicine - studied official data about births in 2013-14, excluding non-standard deliveries such as twins, triplets and pre-term babies.

Different rates of emergency caesarian sections, instrumental deliveries and episiotomies were highlighted in the report.

It said that in some maternity units, eight per cent of mothers needed emergency C-sections, while in others the figure was 15 per cent.

Just under one-in-five first-time mothers needed help with instruments while giving birth naturally in some units while in others the figure rose to almost 30 per cent.

The number of women who needed an episiotomy, where the area between the vagina and anus is cut,  ranged from 29 per cent to 44per cent.

RCOG president Dr David Richmond said: "We are concerned about the amount of variation identified in this report. Although the exact causes are difficult to establish, it is paramount that maternity units have information about their services, as well as being able to compare themselves to the national average and their peers."

To assist, the college has collated the results on an interactive website.

National Childbirth Trust senior policy adviser, Elizabeth Duff, said: "Pregnant women should not have to endure a postcode lottery, and it is unacceptable these variations in maternity care are reported year after year.

"We urge NHS trusts to use this data to examine their practices and ensure the best possible outcomes for mothers and babies."

Health minister, Ben Gummer, said: "Mothers and their babies deserve the very highest standards of care regardless of where they live. The NHS is a safe place to give birth and by being open and honest about variations in care, RCOG's report will help it to improve."