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Are babies born at weekends at higher risk of death?

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    Hannah Blackwell considers a recent research from Imperial College London in which they concluded that babies born in hospitals in England at the weekends have a “significantly” greater chance of dying than those born on week days.

    By Hannah Blackwell

It is not really possible to plan what day of the week your baby is going to be born on and this latest research from Imperial College London which suggests that babies born in hospital at weekends will have a significantly greater chance of dying will no doubt be worrying for expectant mothers admitted to hospitals at weekends.

The issue of a difference between week day and weekend care is not necessarily a ‘new’ issue and my colleague, Kerstin Kubiak wrote previously about shortages of maternity staff at weekends leading to higher risk levels for mothers and babies.

What the Research says

The latest study was carried out by a team at the Imperial College London and was published in the British Medical Journal.  The team looked at the number of still births or deaths within 7 days in hospitals between 2010 and 2012.  The study looked at more than 1.3 million births.

The research took into account risk factors such as deprivation and the age of the mother, along with the fact that planned caesarean sections, which carry low risk, normally take place during the week.

The research noted in total, on average 4,500 deaths a year from 675,000 births.  There were 7.1 deaths per 1,000 babies delivered at weekends.  This was 7% higher than on weekdays.

Researchers found that infection rates for mothers and injuries to babies, including anything from cuts to brain damage, were also higher at the weekend.  The researchers were unable to identify the cause of the increased risk.  They looked at staffing levels in terms of which hospitals were compliant with the guidelines for consultant cover, and found little difference between those that were and those that were not.

Kerstin’s previous blog considered a report by the National Audit Office published in November 2013 which found it was only usually trainee doctors rather than consultants, who are in most hospital obstetric units at night and weekends. That research noted that when the consultants are needed, they are called in from home or give advice over the telephone, which clearly could lead to delay in emergency treatment.

The more recent research by Imperial College concluded that more data was needed on staffing levels before it could be ruled out as a factor.

More to be done?

A spokesman for NHS England said, “we have commissioned a wider independent review of NHS Maternity Services, which will assess how best we can respond to England’s growing birth rate and the need for well-staffed and safe services that give mums more say over their care”.

Dr David Redmond, President of the Royal College of Obstetricians and Gynaecologists, said: “Although no definitive conclusions can be drawn from these results, they emphasise the need to identify the possible causes in order to ensure that women are receiving high-quality care at any given day of the week”.

As specialist medical negligence solicitors, I and my colleagues investigate a large number of cases where a child has suffered brain injury and cerebral palsy where parents have pursued such claims because their children have suffered these catastrophic injuries due to negligent care during their birth.  These cases have included care provided at weekends and have included issues such as delays in obtaining input from senior doctors.  The research from Imperial College and that published by the National Audit Office in 2013 highlight similar concerns and suggest more needs to be done to ensure the care provided to mothers and babies born at weekends is safe and no different from any other time of the week.

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