Huge variations in birth complications across hospital Trusts

A report commissioned by the Healthcare Quality Improvement Partnership as part of the National Clinical Audit Programme reveals a huge variation in number of birth complications and potential for birth injuries across different hospital Trusts and Boards.

The National Maternity and Perinatal Audit Report which is based on the electronic records of almost 700,000 births, covers 149 NHS Trusts and Boards across England, Scotland and Wales and is thought to be the first report of its kind on such a scale. The data was based on births from April 2015 through to March 2016.

The extensive report reveals that whilst the vast majority of new mothers have a safe birth, variation exists across the different NHS Trusts which can impact outcomes for new mothers and may lead to an increase in birth injury claims across these Trusts should negligent care have been the cause.

Notable findings from the report include that haemorrhage during childbirth occurred in approximately one in 40 women however, some maternity units reported haemorrhages in one in 20 of their patients.

Third and fourth degree tears occurred in around one in 30 vaginal births, although the rate was as high as one in 15 in some maternity units across England, Scotland and Wales. In instances where a tear has occurred due to a failure to identify a potential requirement for an episiotomy or a failure to act upon this, patients who have suffered such tears may be eligible to pursue an episiotomy claim as part of a birth injury to mother claim. 

One in 80 babies required additional support in the minutes after birth, as indicated by a low Apgar score. However, some hospitals reported the requirement for additional support in one in 30 babies.

It is important to note that the report cannot factor into account the different patient profiles, for example those with pre-existing medical conditions or other complications, as a result, some degree of variation amongst the different Trusts and Boards is to be anticipated. However, Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecologists said any unexplained variation requires investigation. In instances where the patients have experienced poor care and their outcome has been directly affected they may be eligible to pursue a medical negligence or midwife negligence claim.

Gill Walton, Chief Executive of the Royal College of Midwives said:

“The RCM hopes that maternity leaders will look at this audit and share good practice between units, so those with the highest variation can learn from those with the lowest and in turn improve the safety and quality of our maternity services.”


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