Maternity

Introduction

Swine Flu advice issued by health agencies

Advice about pregnancy and swine flu can be found at the Department of Health, Health Protection Agency and the Royal College of Obstetrics and Gynaecology websites.

Maternity care is undergoing a process of change nationally, with increasing choice for women on how their maternity care is delivered. The basis for these changes lie in the National Service Framework for Children, Young People and Maternity Services (2004) and were confirmed in Lord Darzi’s report High Quality Care for All (2008).

In the north of England, this is reflected in the changes of some of the long-standing consultant-let maternity units becoming midwifery-led units. Within the region that is covered by the Regional Maternity Survey Office (RMSO), there are 17 maternity units, ranging in numbers of deliveries per annum for 2007 from 39 (at Hillcrest Maternity Hospital in Alnwick) to almost 6000 births at the Royal Victoria Infirmary.

Whilst the dedicated staff of these units strive to implement the required changes, there is an imperative to monitor these modifications for the impact on the health outcomes of mothers and babies. NEPHO and its affiliated organisations, including the RMSO are well placed to carry out this surveillance with the expertise and support of relevant clinicians from throughout the region.

Highlight figures

  • 1990s saw a fall in both the number of births and the crude live birth rate in the region covered by the RMSO as elsewhere and this continued until 2001 with a low of 29059 total births. The number has risen steadily to 33818 in 2008.

  • The prevalence rate of gastroschisis (an abdominal wall defect) continues to increase, from 3.0 per 10,000 births in 2000 to 7.1 per 10,000 births in 2008, with a peak of 7.9 per 10,000 births in 2007. Recent figures reported by EUROCAT show that the persistent rise in gastroschisis is a UK, rather than a European-wide phenomenon.

  • The major contributor to perinatal deaths remains stillbirths occurring before the onset of labour (antepartum). A high proportion of these remain "unexplained". Of the 257 perinatal deaths in 2006, 129 (50.2%) were unexplained antepartum stillbirths.