Women's experience of maternity care varies widely according to which hospital they use, shows a report from The NHS Information Centre out today.

In some cases, women being treated in hospitals just a few miles apart experienced markedly different approaches to care, according to the Hospital Episodes Statistics maternity report 2009-10.

In 2009-10, the widest differences reported by NHS trusts included:

• First antenatal assessment - The percentage of women seen for their first antenatal assessment within the recommended first 12 weeks of pregnancy was 89.6 per cent at Royal Cornwall Hospitals NHS Trust - 11 times as high as at Walsall Hospital NHS Trust where the percentage was 8.3 per cent
• Caesarean sections - The percentage of women who had a caesarean at Imperial College Healthcare NHS Trust in London was, at 31.4 per cent, almost twice as high as that at Shrewsbury and Telford Hospital NHS Trust in Shropshire (15.8 per cent)
• Episiotomy - The percentage of women who had spontaneous deliveries with an episiotomy at George Eliot Hospital NHS Trust in Nuneaton was 18.4 per cent which is five times that at Barnsley Hospital NHS Foundation Trust (3.4 per cent).

However, wide variations in care were also apparent in trusts either neighbouring each other or within the same region. For example, the percentage of women to have their first antenatal appointment within the recommended first 12 weeks of pregnancy at Rotherham NHS Foundation Trust (87.6 per cent) was five times the percentage in neighbouring Barnsley Hospital NHS Trust (17.2 per cent). The caesarean percentage at Hereford Hospitals NHS Trust (30.3 per cent) was almost twice that of neighbouring Shrewsbury and Telford (15.8 per cent).

The report also shows in England in 2009-10:

• the number of deliveries in NHS hospitals dipped slightly in the past year, a decrease of 261 deliveries from 2008-09 to 652,377 in 2009-10
• 63.0 per cent (292,637) of women had their first antenatal assessment within the first completed 12 weeks of pregnancy. This compares to 58.3 per cent in 2008-09 (227,773)
• there was no change in the percentage of women having a spontaneous delivery with an episiotomy from 2008-09 to 2009-10, which has remained at 8.3 per cent (33,073 in 2009-10 and 32,834 in 2008-09)
• the caesarean percentage has remained relatively stable at 24.8 per cent (157,356) in 2009-10 compared to 24.6 per cent (154,814) in 2008-09.

Chief executive of The NHS Information Centre Tim Straughan said: “The purpose of the report is to provide national and local comparative data about maternity services to help trusts examine their practices and how they are changing over time.

“The figures show that the experience women have of NHS maternity care varies markedly across the country and even within regions. Rates of caesareans and spontaneous deliveries with an episiotomy as well as access to ante-natal assessment in the first 12 weeks of pregnancy vary according to which hospital they use. In some trusts, there may be specific demographic or clinical reasons that explain why they carry out, for example, more caesareans. But others will need to examine closely the full range of reasons why their rate is different from the national average of about one caesarean delivery for every four deliveries.”

The full report also looks at related issues such as onset of labour, numbers of instrumental deliveries, place of birth and gestation of babies at birth. The maternity provider level analysis tool is also available. These are available at pubs/maternity0910.

ENDS

Notes to editors

1. The NHS Information Centre (The NHS IC) is England's authoritative, independent source of health and social care information. It works with a range of health and social care providers nationwide to provide the facts and figures that help the NHS and social services run effectively. Its role is to collect data, analyse it and convert it into useful information which help providers improve their services and supports academics, researchers, regulators and policymakers in their work. The NHS IC also produces a wide range of statistical publications each year across a number of areas including: primary care, health and lifestyles, screening, hospital care, population and geography, social care, workforce and pay statistics.
2. As a result of changes in methodology, NHS Maternity Statistics 2006-07, 2007-08, 2008-09 and 2009-10 are not directly comparable with previous years, although a number of time series have been reworked based on the new methodology for comparison purposes.
3. Percentages are derived from the total deliveries where the gestation length/method of delivery/ onset method were known.
4. Episiotomy is an incision (surgical cut) made into the thinned-out perineal body to enlarge the vaginal orifice during delivery.
5. For media enquires please call 0845 257 6990 or mediaenquiries@ic.nhs.uk