Many more midwives, obstetricians and anaesthetists are needed if childbirth is to be made safer, say experts. The warning comes in a report by the Royal Colleges representing UK health workers involved in childbirth.
Only 26 per cent of units have enough midwives for one-to-one care, while only about half ensure an obstetrician is on ward duty for at least 40 hours each week.
Figures suggest 13.1 mothers die per 100,000 pregnancies in the UK, and 8.6 babies die per 1,000 births. This figure, which includes both stillbirths and neonatal deaths, has remained static for the last decade.
The Royal Colleges for Obstetricians and Gynaecologists, Midwives, Anaesthetists and Paediatricians' report examines how safety could be improved. It also highlights the fact that in the decade between 1995 and 2005 obstetric-related litigation payouts totalled £1.5 billion, nearly tripling in value in the five years between 1996 and 2001.
The report's recommendation that all women in established labour receive one-to-one midwife care echoes recent guidelines issued by the National Institute for Health and Clinical Excellence (Nice). But in order to provide this, the Royal College of Midwives says an extra 5,000 trained professionals are needed in England alone.
For its part, the Royal College of Obstetricians and Gynaecologists says the number of consultants across the UK needs to increase immediately from the current 1,600 to at least 2,100 and ideally 2,500.
The report also stressed that there should be more consultant presence on the wards and as late as possible into the evening.
This is because several major studies have shown that deaths, when they happen, tend to occur in the hours between 22:00 and 04:00, when there is least likely to be a consultant on duty.
A duty anaesthetist must also be immediately available for the obstetric unit 24 hours a day.
The report focuses mainly on improvements in hospitals, but the authors also backed the government's desire that every woman should have the choice of where she gives birth, be it at hospital, at home, or in a midwife-led unit.
While giving birth outside a consultant-led ward is generally felt to reduce the amount of medical intervention, there is research suggesting that when problems do arise, the outcome for mother and baby may be worse.
As many as 30 per cent of first time mothers giving birth outside hospital will need to be rushed in as emergencies. Units needed to be properly staffed to deal with these, the report stressed.
Source: BBC News 08/Oct/07