Maternity Care Mother and Baby

A recent article in the British Journal of Healthcare Management titled: Safe birth: at last, it’s everyone’s business (subscription required) made for interesting but not surprising reading. The good news was that Maternity Services in the UK are overwhelmingly safe but still not safe as it could/should be. The report from the Kings Fund – Safe births focused on the what can be done to improve the situation

There are many drivers helping to improve things but costs in the UK are currently not one of them despite “50% of all litigation payouts int he NHS being associated with Maternity Care

There are also considerable financial penalties associated with failure. Litigation costs as a result of failure in maternity care make up 50% of all NHS Litigation Authority (NHSLA) payouts. Yet trust boards, because of the pooled approach to payment as a result of the Clinical Negligence Scheme for Trusts (CNST) and NHSLA, have been cocooned from the full financial cost of failure.

But the point that safety is “everyone’s business” is an important one and relevant to everyone – not just the clinical staff.

Childbirth is a natural process and intervention is not always a good choice for mother or baby. The guidelines when picking an obstetrician or midwife should include at least these questions as suggested by the Childbirth Connection group

• How do you feel about epidurals?
  How do you feel about labor induction?
  How often do you cut episiotomies?
  What are my options if labor slows down or stalls?
  During labor, can I have my baby monitored with a handheld device or occasional electronic fetal monitoring (EFM) rather than continuous EFM?
  What are your rates for Cesarean section, assisted vaginal delivery and episiotomy?

Just in case anyone gets the wrong idea – I am not suggestion no intervention, just the process fo an informed decision that includes an understadning of what the choices are and what they mean to mother and baby.

You can read more about the US experience in my Accelerating the Adoption of IT in healthcare Blog here