Proportion of induced labours rise

By Hollie Ewers on 26 October 2018 Smoking Report Obesity Induction NHS

New maternity figures show that there has been a rise in the proportion of induced labours in NHS hospitals.

Inductions have increased from 29.4% in 2016-17 to 31.6% in 2017-18 according to Hospital Episode Statistics (HES) in the NHS Maternity Statistics 2017-18 report published yesterday (25 October).

The rise follows a continuing trend since 2007-08 when induced labours accounted for 20.4% of births.  

Also shown to be increasing is the proportion of CSs undertaken before the onset of labour from 15.5% in 2016-17 to 16.2% in 2017-18. Spontaneous labours decreased from 55.1% to 52.2%.

In comparison, in 2007-08 11% of births were via CS before the onset of labour and 68.6% were through spontaneous labour.

RCM head of quality and standards Mandy Forrester said that the statistics are useful to gauge an overall picture of what is happening within maternity services.
She added: ‘There has been a small rise in the number of women having CSs and this could be for a variety of reasons. There will always be women, who for medical reasons need a CS, but for many they are not needed. What is crucial is that women are aware of the potential complications of having a CS in the short and long term. To ensure this happens we need to give midwives the time to sit and discuss a woman’s options for the birth of her baby.
‘NICE guidelines on CS support midwives and their colleagues to in turn support women to make informed decisions when it comes to CS. Also, induction is based on risk assessment and what is clinically appropriate and what the woman decides after discussion with her care provider (usually the obstetrician). The midwife’s role is to support the woman in her choice.’

Additional figures in the report reveal that 81% of women with babies born at 37 weeks’ gestation or more had skin-to-skin contact within one hour of birth in 2017-18. 

And, of the 389,000 babies submitted to the Maternity Services Data Set with a recorded feed type, 74% received breastmilk or donor milk for their first feed.

Mandy said that these figures were positive to see: ‘Skin-skin contact is so important for the overall health and wellbeing of both mother and baby and clinicians should make every possible effort for all babies to have skin-to-skin contact with their mothers within one hour of birth.

‘For women who choose to breastfeed it’s vitally important that they receive support from midwives so they can initiate and sustain breastfeeding for longer, but they also need support from their family, friends and wider society, particularly when it comes to breastfeeding in public.’ 

The report also covers statistics for both smoking and weight, with figures revealing the proportion of births in 2017-18, where the mother was recorded as a current smoker at the booking appointment, was 31% of women aged under 20.

In comparison, among women aged 40 and over, 6% were smokers at their booking appointment.

The proportion of women with a BMI in the obese range (over 30) was lowest for those aged under 20 (14%) and highest for those aged 40 and over (24%).

‘The recorded rate of women under-20 smoking is far too high and it must be tackled as matter of urgency,’ said Mandy. 

‘Midwives are committed to ensuring the women they care for have the safest possible pregnancy and supporting them to stop smoking is part of achieving this. However, the provision of stop smoking services in place around the UK is often patchy.’

On the proportion of women over 40 presenting with a BMI in the obese range, Mandy said this is also far too high, particularly when there is a continuing trend of women choosing to have babies in their late thirties and forties.

She added: ‘We know obesity and smoking can have an impact on stillbirth rates and women who are overweight do require extra surveillance throughout their pregnancy.

‘The RCM recommends that women should try to be an ideal weight before they become pregnant and, if not, should follow midwifery advice to manage their weight. Women who are overweight or obese will also need support and signposting to access weight-loss services to ensure that they are an ideal weight before they embark on their next pregnancy.’

The report confirms there were 626,000 deliveries in NHS hospitals during 2017-18, a decrease of 1.6% from 2016-17. This is the lowest reported level in the past 10 years.

Read the report in full here.