Health alert on problem births

Growing numbers of older and obese mothers and rising rates of IVF treatment are putting babies at risk, a hard-hitting new report into maternity services will warn this week.

A year-long investigation by the King's Fund, the authoritative health think-tank, blames trends in women's lifestyles for contributing to the growing pressures faced by doctors and midwives in maternity units.

The inquiry, led by Baroness Onora O'Neill, president of the British Academy and a leading expert on medical ethics, has been looking into why some women and babies suffer serious injury or even die during childbirth.

She and a team of experts have concluded that maternity staff are struggling to cope with a heavier and increasingly complicated workload, and that major improvements are needed.

The rising birthrate is also putting extra strain on a system which many experts believe needs to be far better staffed in order to reduce problematic births, O'Neill's team will say.

The report will be a further blow to public confidence in maternity provision. The expert panel took evidence from dozens of organisations involved in maternity care and visited hospitals across Britain to examine how well or badly they handled the 700,000 women a year who give birth.

Consultants in obstetrics and gynaecology, midwives and hospital managers told the inquiry that older mothers are running a greater risk of their own health, or their baby's, being damaged, for example by needing a surgical intervention because of complications. Women aged 40-44 are much more likely than normal to suffer a stillbirth, for example.

There is also widespread concern that growing numbers of women are in far worse physical shape to give birth than in previous years, especially because so many are obese.

However, the inquiry will stress that maternity professionals are doing a remarkably good job, despite these growing pressures on their time and expertise. It will also highlight hospitals where maternity safety procedures are first-class, such as the Liverpool Women's Hospital and John Radcliffe Hospital in Oxford, and recommend that others implement similar measures to benefit patients.

The report will also disclose that recommendations made to improve maternity safety in a series of earlier inquiries have not been implemented across the health service.

The Royal College of Obstetricians and Gynaecologists wants the NHS to hire hundreds more consultants to ensure that maternity units have a senior doctor on duty over much longer hours than at present, especially because of increasingly complicated case loads. But the King's Fund report will warn that the amount of time consultants spend on labour wards will soon start to fall because the European working time directive will impose a 48-hour working week on them.

The Royal College of Midwives is urging ministers to recruit 5,000 more midwives so that wards have enough staff to ensure that all mothers and babies receive the best possible standards of care.