National Maternity Statistics 2023-24 (A Breakdown)
Interventions don’t always make things safer
(What we can learn from the 2023-24 Maternity Statistics)
It’s always a tricky conversation to start, the one about interventions in birth.
Given how many women experience them, how many maternity staff are involved in recommending them, and how prevalent they are in modern maternity care- there’s quite a lot of people that can find the conversation upsetting, judgemental or confronting..
So whilst it shouldn’t need it, I will preface this conversation with
The rising rate of intervention is not the fault of individual women giving birth, and a woman isn’t ‘better’ or ‘worse’ than another because of how she birthed her baby.
There are many incredible individual clinicians working in an overstretched, under resourced system- and this post isn’t about them
There are situations where intervention can be life saving, life altering (in a good way), much needed or much wanted by the women utilising them, and my god are we lucky to live in a part of the world where these are free (at the point of need).
Today, the National Maternity Statistics were published.
This looks at the birth outcomes of births in England between 2023-2024.
In short, (unsurprisingly for anyone working in maternity care), this is what they showed:
National Maternity Statistics 23-24
Spontaneous onset (labour starting on its own) (42%) DOWN
Unassisted vaginal Birth (45%) DOWN
Planned & Unplanned Caesarean (41%) UP
Instrumental birth (11%) UP
Induction (33%), same as last year.. Highest ever rate in history.
Ok, so intervention rates are climbing year on year. So, you’d expect to see a similar, staggering improvement in outcomes, right?
Only this is the issue.
We are not.
According to the National State of Patient Safety Report and the National Maternity Statistics 2024, published today- this is what’s happening:
1 in 4 women are experiencing a postpartum hemorrhage
More than 1 in 4 babies are not receiving skin to skin contact within an hour of their birth
More than 1 in 4 babies are not receiving breast milk as their first feed
Maternal deaths per 100,000 maternities increased from 9.71 in 2022 to 13.41 currently
Stillbirth rate increased from 3.33 to 3.52 per 1000 births
Neonatal death rate increased from 1.55 to 1.6 per 1000 births
So what’s going on?
Quite rightly, there have been many (many, many, many) enquiries and reports into maternity care over the last decade. All made (generally pretty similar) recommendations to improve outcomes. Many of which focussed on staffing levels, workforce culture and LISTENING to women (especially when requesting a caesarean birth or reporting concerns). In an attempt to distance themselves from what was reported as ‘the cult of natural birth’ (leading to poor outcomes where women’s concerns were not listened to or escalated appropriately); ever narrowing parameters in guidance for ‘low risk’ pregnancy classification & access to midwifery led care, and staffing shortages leading to the closure of homebirth and midwifery led unit services- maternity services have moved into an extremely medicalised, high intervention model of care. But as we can see from today’s published statistics, this hasn’t been the answer.
Birth trauma is rising, the long term impact of such high rates of intervention is ultimately unknown, and things continue to get worse, not better.
It’s easy to look at these numbers and disconnect them from the real people they are affecting. The real families, women and children having to live forever with the physical, emotional, relational and health consequences of these birth experiences. But if you’re reading this currently pregnant, feeling very much like a real person, not a 0.01% of a statistic, what do you even do with this information?
It has never been more important to take control of and responsibility for your birth preparation. You shouldn’t have to, but if you want to step off the conveyor belt of care and take back power over the decisions being made about your pregnancy, your birth and your baby- you must.
This is what I would recommend (and how I can help!)
Learn about the basics of birthing physiology. When you’ve done this, you’ll begin to see how our modern approach to birth can trip us up and cause complications where there might not otherwise have been any.
Learn about how the maternity system works. Think - understanding guidelines, research, data (like this)- so you can make truly informed decisions about your care. Understand how hierarchies in maternity services, politics, relationships are all going to impact what you are told to do, so you can work out whether or not these recommendations feel helpful to you or not.
Learn about your full breadth of birth choices- not simply your pain relief choices or birth place options, but all the nuances and intricacies in between, that can be the difference between a passive and an empowered birth experience.
Antenatal education provided by maternity services will NOT give you these things.
This is exactly why I created The Birth-ed Method, it’s exactly why I host The Birth-ed Podcast- so you have the straightforward, accessible, empowering information about birth you deserve. This so isn’t about giving birth a specific way. It’s about getting you as close to whatever kind of birth you are hoping for- in the safest, most satisfying, most powerful way possible.
You are not a statistic.
You are a very special, important, valuable mother.
Carrying a very special, important, valuable baby.
And I am here to make this all feel a bit less scary, and a lot more ‘yes I can fucking do this’ (however you want to do it!).
Ready to take back the power?
Join The Birth-ed Method here.
References
https://timms.le.ac.uk/mbrrace-uk-perinatal-mortality/surveillance/
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthsummarytablesenglandandwales/2023#:~:text=5.,Other)%2C%20from%203.5%20to%203.4
https://www.imperial.ac.uk/Stories/National-State-Patient-Safety-2024/