NHS Maternity Statistics, England: 2008/09

The new NHS maternity statistics for England 2008-9 were released today.

Belinda Phipps, Chief Executive, NCT, says;
“Again we have a release of figures that show the situation for women and babies is getting worse – high caesarean section rates, increased medical interventions, and fewer women giving birth in a place appropriate to them.

“This clearly demonstrates the effect of the lack of progress on Maternity Matters, the governments choice of place of birth promise, which was highlighted in the NCT’s  Location, location, location research report this week. Choice of place of birth leads to better birth outcomes for women, increased likelihood of a straightforward birth and improved satisfaction with the birth. “

Key Points

The caesarean rate has remained the same at 24.6%, with a rise in the numbers of elective caesareans (0.1%) and a decrease in the number of emergency caesareans (0.1%).  This shows a halt in the trend of increasing caesarean rates.
The instrumental delivery rate has increased by 0.1% to 12.2%, with a rise in the forceps rate from 5.0% to 5.5% and a decrease in the use of ventouse of 0.4%.  This continues the trend of increasing instrumental rates.
The induction rate is down 0.2% to 20.2%.  This reverses the recent upward trend.  Since 1999-2000 there had been an overall downward trend, with a low in 2005 but the rate has subsequently risen again.
Normal delivery rates are not available at the moment.  It is hoped the Information Centre will make these available in due course.

68.8% of women had a spontaneous onset of labour, similar to the previous year which was 68.6%.  [Note: this calculation uses a different source for caesarean as method of onset of labour, which is shown as 11%, rather than the 9.8% shown in Table 32, and does not reflect the rise of 0.1% in elective rates over the year]

62.9% of women had a spontaneous delivery, the same as from 2007-08.  This is at an all-time low.

	2006/07	2007/08	2008/09
Caesarean Rate	24.3%	24.6%	24.6%
Elective	9.5%	9.7%	9.8%
Emergency	14.7%	14.9%	14.8%
Instrumental Delivery Rate	11.5%	12.1%	12.2%
Forceps	4.5%	5.0%	5.5%
Ventouse	7.0%	7.0%	6.6%
Induction Rate	20.3%	20.4%	20.2%
Care on GP/Midwife Ward	10.6	11.7	10.8%
Normal Delivery Rate	n/a	n/a

 

Highs and Lows

There are 8 trusts/maternity units with caesarean rates above 30%:

 

Chelsea and Westminster Hospital	33.3%
Imperial College Healthcare NHS Trust (St Mary’s Paddington and Queen Charlotte’s)	33.1%
East Surrey Hospital	30.9%
Barnet Hospital	30.8%
University Hospital, Lewisham	30.6%
University College Hospital, London	30.6%
Royal Sussex County Hospital, Brighton	30.5%
Royal Free Hospital, Hampstead	30.4%

 

There are 5 trusts/maternity units with caesarean rates below 19%.

Kings Mill Hospital, Sutton-in-Ashfield, Notts	15.8%
Royal Shrewsbury Hospital	16.9%
Pontefract Hospital (part of Mid Yorkshire Hospitals NHS Trust)	17.8%
Barnsley Hospital	18.1%
Salford Royal Hospital	18.8%%

Midwife led care

Data for the current years show no increases in births in NHS midwifery facilities – 9.5% in the current year compared to 9.6% in 2007-08.  Care on consultant wards has increased from 44.7% to 48.8%.

Background – Since 1989-90, data have been collected on the place of delivery.  This uses the following categories:

1. NHS consultant ward
2. NHS GP ward
3. NHS combined consultant/GMP/midwife ward
4. NHS midwife ward/other ward or with delivery facilities associated with midwife ward or unit without delivery facilities

These categories are historical and do not necessarily represent current configurations of alongside birth centres, standalone birth centres, midwife led care beds in an obstetric.  Nonetheless, they can indicate changes in patterns of care.

Year	Total deliveries	Total with known place of delivery	Record completeness	Consultant Ward	Consultant / Midwife / GP Ward	GP ward	Midwife ward / Other ward	Total of midwife plus GP led care
2005-06	611,337	360,273	59%	49.4	41.5	1.6	7.4	9.0
2006-07	629,207	378,439	60%	45.9	43.5	2.3	8.3	10.6
2007-08	649,837	305,930	47%	44.7	43.6	2.1	9.6	11.7
2008-09	652,638	495,535	76%	48.8	40.4	1.3	9.5	10.8

 

This shows a decrease in GP/midwife led care in the previous year, and an increase consultant led care. However, record completeness is much higher than in previous years and changes may reflect a more representative sample than in previous years rather than changes in configurations.