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RCM highlights maternity care variations

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Women should receive good maternity care wherever they live and should not have to rely on “chance and plain old good luck,” the Royal College of Midwives (RCM) has said.

Cathy Warwick, general secretary of the RCM, spoke out after NHS figures showed wide variations in a woman’s experience of maternity services depending on where she lives.

Caesarean rates vary according to health trust, with Imperial College Healthcare Trust in London having a rate of 31.4% of all births, almost twice as high as that at Shrewsbury and Telford Hospital Trust in Shropshire (15.8%).

The national average rate across England is 24.8%, according to the NHS Information Centre study, which examined figures for 2009/10.

It found variations in the percentage of women seen for their first antenatal appointment within a recommended 12 weeks, with 89.6% seen within the timeframe at Royal Cornwall Hospitals Trust.

This figure is 11 times higher than the 8.3% seen at Walsall Hospital Trust.

Overall, 63% of women had their first antenatal assessment within the first 12 weeks - up from 58.3% in 2008/09.

The report also found wide differences between NHS trusts in close proximity to each other.

The proportion of women seen for their first antenatal appointment within 12 weeks was 87.6% at Rotherham Foundation Trust - five times higher than that in nearby Barnsley Hospital Trust (17.2%).

Meanwhile, the caesarean rate for Hereford Hospitals Trust (30.3%) was almost twice that of neighbouring Shrewsbury and Telford (15.8%).

Overall, the number of deliveries in NHS hospitals in 2009/10 fell by 261 deliveries on the previous year to 652,377, the report also showed.

Professor Cathy Warwick, general secretary of the Royal College of Midwives (RCM), said: “The variation on the first antenatal booking is astonishing and those on caesarean section rates - already widely known - are worrying in their persistence at such a level.

Professor Warwick said some of the variations could be down to staffing levels. “It could also be related to how services are organised,” she added.

Tim Straughan, chief executive of the NHS Information Centre, said: “The figures show that the experience women have of NHS maternity care varies markedly across the country and even within regions.”

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