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Injury during childbirth: maternity care varies across England


    There are wide variations in the quality of care during childbirth in England, according to a research report by doctors and this is mirrored by the experiences of our clients

    By Kerstin Kubiak

Research carried out by the Royal College of Obstetricians in 2011/2012 shows a wide variation in standards of maternity care in England. The report is intended to help clinical staff to improve standards.  It also confirms the impression gained from within our caseload that basic and avoidable errors are being made, and injuries being suffered during childbirth, due to problems with staffing, although it is recognised that it is hard to draw conclusions about the standards at individual units from such a limited sample from across England and Wales.

The Royal College’s research, carried out in conjunction with the London School of Hygiene and Tropical Medicine, demonstrated that there was a wide variation in guidelines and routines and the number of adverse outcomes at different maternity units.  The research was carried out using 11 indicators of the quality of maternity care and data routinely collected by hospitals, including statistics for:

  • the number of induced labours
  • emergency caesareans after induction
  • deliveries involving instruments such as forceps
  • severe tears during labour
  • emergency readmissions of mothers after delivery.

Staffing levels

These statistics have to be interpreted with caution due to variation between different geographical areas.  Even so it is very noticeable that practice can be different in midwife-led units and there is a great deal of political pressure to avoid arguments between the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives in relation to standards and staffing levels.

As recently as April 2013 ITV news has reported in the North West of England that “…midwives are being pushed to tipping point because there are just enough to cope with the rising number of births. With England in the midst of a baby boom, there are warnings that new mums are being put at risk because midwives aren’t able to give them the one to one care that they need. Despite a 21% rise in the number of babies being born in the North West, midwife numbers actually fell by 4%.”

A frequent view is that individual clinicians are being required to supervise too many births at once and so symptoms that would be obvious if they had more time are missed.

In the same way, increasing use of agency and junior staff can lead to a failure to spot a pattern of deterioration in a patient. For example, a recent claim investigated by a member of the Clinical Negligence Team, highlighted an issue that individual snapshot blood pressure measurements viewed in isolation by different members of a team during labour may not cause alarm but because the patient was almost never seen by the same clinician twice her global deterioration went unnoticed until it was too late and she sadly died.  The damages awarded to her widower and children were substantial and only had to be paid because of staffing problems which meant that the mother did not have the continuity of care which would have saved her life.

It is important if you consider that you may have suffered an injury or wish to consider suing a doctor or suing the NHS that you contact a specialist medical negligence lawyer. A claim for compensation can assist in improving the lives of those significantly injured during childbirth.

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