Call for more maternity doctors

Pregnant woman Older women may have more complications during pregnancy

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The NHS needs more specialist maternity doctors to prevent mothers dying due to "substandard care", experts have said.

An editorial in the British Medical Journal written by six obstetricians says most maternal deaths are now caused by treatable medical conditions.

The Royal College of Obstetricians and Gynaecologists says too few doctors means warning signs can be missed.

The Department of Health said it was committed to seeing every woman getting safe and quality maternity services.

It says linking women's health services in networks will help.

By partnering obstetrics with other medical specialties such as cancer, heart, respiratory and mental health, care can be provided in a continuum, reducing maternal and child deaths, says the RCOG.

It says there are increasing demands on doctors as a result of the increasing birth rate and higher numbers of pregnancy complications that need to be assessed and treated.

Maternal deaths

For the three years from 2006 to 2008:

  • 107 mothers died of conditions that could only have arisen if they had been pregnant (direct deaths)
  • 154 died of indirect causes, including infections and underlying health problems

Source: Confidential Enquiry into Maternal Deaths report

Increasing numbers of women with often complex medical conditions are now becoming pregnant or seeking fertility advice. And with more women delaying starting a family, doctors are now seeing more older women with complicated pregnancies.

The latest review of UK maternity services - the Confidential Enquiry into Maternal Deaths report - found that although the overall maternal death rate has been declining, there has been an increase in maternal deaths associated with existing medical conditions, like diabetes, epilepsy, asthma or heart failure.

And many of these are linked with substandard care, meaning more could have been done by healthcare professionals.

In a third of these cases, different care might have actually prevented the death of the mother.

Professor Catherine Nelson-Piercy and her obstetric colleagues say in the BMJ "these failings need urgent attention".

They are calling for the training and appointment of more obstetric physicians who specialise in the care of women with medical problems in pregnancy.

The BBC's Panorama recently reported that proper maternity care could have prevented the deaths of 17 women in London over 18 months.

And the Royal College of Midwives estimates that at least an extra 4,700 midwives need to be employed across England and Wales to provide a safe service.

A Department of Health spokesman said: "There has been a significant reduction in the number of women dying during pregnancy in the UK, but every death is one too many. We are committed to ensuring that every woman gets safe and quality maternity services.

"Over the last decade we have seen a 46.6% increase in the number of doctors in obstetrics and gynaecology and a 64.4% increase in consultants."

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