Key findings

Summary results from the National Maternity and Perinatal Audit first clinical report, based on births from 1st April 2015-31st March 2016 in England, Scotland and Wales.

Less than half of pregnant women have a body mass index within the normal range and 21.3% are classed as obese (BMI of 30 or over). The high level of maternal obesity has implications for maternity and neonatal service provision.

More than half of pregnant women are over 30. In England and Scotland, the proportion of women having their first baby at the age of 40 or over (2.7%) is higher than the proportion having their first baby before age 18. Increasing maternal age has implications for clinical outcomes and maternity service provision.

Among women giving birth vaginally to a singleton, term baby, 3.5% sustain a third or fourth degree perineal tear, which can give rise to long term continence problems.

The proportion of women affected varies from 0.6% to 6.5% between maternity services, even after adjustment for case mix.

Obstetric haemorrhage is associated with risk of maternal illness and death.

2.7% of women giving birth to a singleton, term baby in England and Wales have a haemorrhage of 1500ml or more.

The proportion of this varies between maternity services, from 1.1% to 5.6%, even after case mix adjustment.

1.2% of babies born at term in Britain have an Apgar score of less than 7 at five minutes of age, which is associated with short and long term morbidity.

This proportion varies between maternity services, from 0.3% to 3.5%, despite adjustment for case mix.

Babies who are small for gestational age below the 10th centile at term have an increased risk of being stillborn and having severe neonatal complications. Guidelines recommend that these babies are born before their estimated due date.

Over half of all babies born small for gestational age at term are born after their due date.

This would suggest that these babies are currently not identified by local or national guidelines in use.

Planned birth in the early term period (at 37 or 38 weeks) increases the risk of illness for the baby.

28.7% of women having an elective delivery prior to 39 weeks currently have no documented clinical indication; this rate is higher in Wales and Scotland than in England.

Although some services achieve high rates, there is wide variation in the proportion of babies receiving skin to skin contact within the first hour after birth, which has been shown to improve the rates of women starting and continuing to breastfeed, and in the proportion of babies receiving breast milk for their first feed.

Although the majority of obstetric units are co-located with an alongside midwifery unit in England, only around 13% of women are estimated to give birth in a midwife-led setting (of those where place of birth could be determined).