Researchers at Imperial College, London have published a report in the British Medical Journal, assessing weekend maternity care and deliveries, compared with those during the week, which suggests that outcomes are worse with higher rates of stillbirths and perinatal deaths following weekend delivery.
A separate and now controversial study published earlier in the year suggested that across the board patients were at greater risk of adverse outcomes during weekend admissions to hospital. The use of some of the data from that report in Parliament, by Health Secretary Jeremy Hunt, has led to the so called ’Hunt effect’ and allegations that patients are delaying admission to hospital at weekends for fear of inadequate care.
The maternity care study looked at more than 1.3 million births and found that there were 7.1 deaths per 1,000 babies delivered at weekends and that this was 7% higher than on weekdays. The study excluded factors such as planned caesareans taking place during the week.
The reasons for this are unclear as so far as stillbirths are concerned often the death of a baby in utero will have arisen some days before delivery takes place.
In addition to the risk of stillbirth, infection rates for mothers and injuries to babies were also higher at weekends.
Commenting Louise Silverton director for midwifery at the Royal College of Midwives (RCM) says;
The study itself does not give a reason for why these ‘effects’ occur. Midwifery and maternity staffing levels are the same on weekends as they are on weekdays. Midwives work across 24 hours, 365 days per year.
Maternity units are already working at full capacity with greater demand for care with increasing complications. We are already 2,600 midwives in England alone.
The authors of this report have a stressed that this study is just an observational study and that no ‘definite conclusions’ can be drawn about the cause and effect of weekend deaths.
We need to make sure that we identify the ‘possible causes’ so we can continue to ensure women receive the best possible care for both them and their baby.”