An alarming new study in the British Medical Journal concludes that babies are at a higher risk of dying soon after delivery if they are born outside normal working hours.
Janet Scott, Research Manager, Sands, commenting on the new report said, “It is shocking that some babies are dying in our maternity units directly because the quality of care at night and at weekends is of a poorer standard than care during working hours."
“Had these babies been born at a different time of day they may well have survived. This is completely unacceptable. A baby’s life should not rest on whether or not they are born in office hours.”
Janet Scott continues, “This study confirms the stories that Sands hears time and again from parents whose baby has died and who feel the care they received was below standard because the staff were poorly prepared to deal with the unexpected or that it took too long to access the facilities that might have saved their baby’s life. The loss of a baby is hard enough to bear, but it is even more agonising if you know that the death might have been avoided.”
“We have known for well over a decade that sub-optimal care leads to avoidable deaths.( CESDI). This study adds to the evidence that babies’ lives are put at risk when access to experienced staff and facilities is limited, such as outside normal working hours. Babies do not conveniently time their arrival to coincide with office hours and mothers should know the maternity care available is equally good whenever they deliver.”
Possibly a quarter of the term neonatal deaths due to anoxia in labour (a sensitive measure of care in labour and delivery) were due to the increased risk of delivering at night and weekends. Furthermore the study suggests there may be a similar increase in the risk of stillbirth in labour.
The implications of these findings for the organisation of maternity care across the UK cannot be ignored. Sands is calling for urgent action to investigate exactly what it is about the care at night and weekends that leads to an increase in the risk of death, and services must be improved accordingly, without delay. The study looked at deliveries during a period when staffing levels were increasing suggesting that the profile, experience and standard of training of medical staff as well as access to obstetric facilities is as important as overall staffing numbers.
The study looks at Scottish data, but it’s reasonable to assume the same is true for the whole of the UK where data sets are less detailed. With 6,500 stillbirths and neonatal deaths a year in the UK, it is critical that the quality of care 24/7 is taken very seriously indeed.
Please follow the link for the research article in BMJ online www.bmj.com/cgi/content/abstract/341/jul15_1/c3498