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Audit reveals significant variations in UK maternity care

Tuesday 14th November 2017
Vaginal tears during childbirth are significantly more likely at some NHS hospitals than others, new data shows. Image: g-stockstudio via iStock
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    Complications in childbirth are significantly more likely in certain parts of the country than others, the results of a comprehensive new audit reveal.

    The newly-released National Maternity and Perinatal Audit shows that severe blood loss, tears and other complications are much more prevalent in some hospitals, meaning further investigations are needed to find out why.

    This could also mean that extra nurses and midwives are brought in to try to resolve some of the issues and ensure expectant mothers are receiving the highest possible standard of care.

    Data was gathered from 149 of the 155 NHS Trusts in England, Scotland and Wales for the audit.

    It was found that, on average, third and fourth-degree tears occur in one in 30 vaginal births, often resulting in dangerous blood loss.

    Women giving birth at the Royal Sussex County Hospital were found to be at highest risk of obstetric anal sphincter injuries, with these tears occurring in 6.5 per cent of all mothers delivering babies there. In stark contrast, just 0.6 per cent of women treated at Dr Gray's Hospital, part of the NHS Grampian Trust, suffered the same injuries.

    Meanwhile, haemorrhages occurred in one in 40 births, but at some hospitals their prevalence increased to one in 20, again indicating a marked variation in care standards depending on where in the country a woman gives birth.

    The audit data also showed that more caesareans took place in England (20.7 per cent of all births) compared to Scotland (19.7 per cent) and Wales (15.7 per cent), while assisted vaginal deliveries - such as those requiring forceps - accounted for 13.6 per cent of all UK births.

    Commenting on the audit results, Professor Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists, stated: "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."

    Written by James Puckle

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