More obstetricians and increased training are needed to reduce fatalities, it has today been claimed.
Catherine Nelson-Piercy, professor of obstetric medicine at King’s College London, and five colleagues, have called for action in the
BMJ.
The authors argue that ‘most of these deaths are associated with substandard care, and in one third of cases this is classified as major substandard care, where different care might have prevented death of the mother. These failings require urgent attention’.
The latest review of UK maternity services, the
Confidential Enquiry into Maternal Deaths report, found that the overall maternal death rate is declining, but the number of maternal deaths due to ‘indirect’ causes has significantly increased.
The editorial in the
BMJ states that more training is needed for doctors so that they are alerted to the possible underlying problems when pregnant women present with symptoms such as breathlessness, headache and abdominal pain.
The authors also claim that the number of obstetricians needs to be increased and that this sub-speciality should be formally recognised.
RCOG welcomes the call for action and says the recommendations its recent
High Quality Women’s Health Care report, to introduce women’s health networks in the NHS, would help in improving the care of women and reduce maternal and child deaths.
These networks would link the range of women’s health services together with other specialties such as cancer, heart, respiratory and mental health so that care can provided in a continuum.
Dr Tony Falconer, RCOG president, said: ‘The reason direct obstetric deaths have reduced over the years is due to improved organisation of clinical cover and more uniform care through adherence to national clinical guidelines.
‘We must ensure that this trend improves through increased senior presence on the labour ward for those patients needing immediate access to such care.
‘The RCOG pioneered sub-specialty training in areas of clinical need such as fetal and maternal medicine and the next step in the evolution of services is to link all these different parts together through networks which we believe will provide better care, improve outcomes and drive up quality.’
