Maternity Care is Unequal Across England

A report by doctors shows expectant mothers in England experience wide variations in their quality of care

The quality of maternity care is unequal across England, a report by leading doctors has found.

Official data shows the rate of inductions, emergency caesareans and assisted deliveries are twice as high in some hospitals than others. These inequalities suggest that some women are not receiving the best possible care, warns The Royal College of Obstetricians and Gynaecologists (RCOG).

In the groundbreaking report, the RCOG analysed the performance of maternity units in England in 2011 and 2012.

The research focused on 11 indicators of the quality of maternity care, using data collected by hospitals. The results showed a wide variation in practices at different maternity units throughout England.

For example, among first-time mothers, there was a two-fold difference between hospitals with the highest and lowest rates of induction of labour (17 per cent to 38 per cent), emergency caesarean section after induction of labour (20 per cent to 40 per cent) and instrumental delivery (16 per cent to 32 per cent).

The research is the first step towards establishing indicators that can be used by maternity services to supervise and improve quality of care, said Dr David Richmond, vice president of RCOG.

‘The initial set of indicators suggests wide variation in both practice and outcomes between maternity units, which is a source of concern for the specialty as we cannot be sure that every woman is getting the best possible care,’ he said.

‘It highlights that specialist-delivered care must expand, so that for women with complex obstetric needs care can be provided by trained clinicians 24 hours a day and seven days a week.’

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