Let's Talk About; NHS Maternity Birth Statistics

Each year the NHS publishes statistics relating to what they call ‘maternity activities’ in each of the English NHS Trusts where maternity services are available. To you and me that simply means data relating to pregnancy and birth in English NHS Hospitals. I’m not sure I know anyone who would call their birth a ‘maternity activity’ but maybe that’s by the by?

The data gives us a statistical insight into what is happening in care settings across England. The numbers can help us understand what maternity care looks like, how ‘likely’ or ‘unlikely’ certain things are and the way in which the system of birth works. In some cases the report also covers the previous decade’s worth of data which means we’re also able to look at the longer term patterns for some factors.

BEFORE WE START...

I'd like to make a caveat. It's worth remembering that the statistics are only part of the picture. Behind each number is human experience. The mothers, babies, partners, families and care providers are the oft forgotten people behind the numbers. Each of them has their own story to tell. Their own experiences, reactions, feelings and opinions.

Whilst the numbers are objective (and ‘objectivity’ is something we tend to value highly) they do not tell us about the subjective context and experience. They miss out and overlook the nuance and choices that are present in all pregnancies and births. They don’t tell the stories of those navigating through the systems. In that way, they can be a blunt tool for decision making when it comes to your own care. Just something to bear in mind as you work your way through it.

OK. SO WHAT'S GOING ON?

I personally think it's easier to look at this stuff when it looks pretty so I've put the details in the image gallery below. I've also compared this data to the same date for the years 2010/11 (where possible) so you can have some idea of the longer term trends.

Here are some of the headlines you may want to know about:

In 2020/21

53% spontaneous vaginal births
33% Caesarean births
12% assisted vaginal births (using ventouse or forceps)
34% induction rate (not including membrane 'sweeps')
18% planned Caesarean Births
Fewer than half of those mothers aged over 40 had a spontaneous vaginal birth
1 in 10 babies born weighted over 4Kg - the weight which the NHS considers to be a 'big baby'.
Emergency Caesarean births are 8% more likely to happen if you are black or brown than if you are white.


OK, THAT'S A LOT TO TAKE IN

Broadly speaking when you look at the statistics we can see upwards trends in birth intervention (such as induction and assisted births), caesarean rates, and an apparent decrease in the number of what would be considered normal, physiological vaginal births.

Each year when these statistics are published they prompt strong reactions from those who work in the world of birth or those who feel impacted by them. The responses range from ‘This is outrageous, we must fix this broken system immediately’ to ‘Well, duh - tell us something we don’t already know!’
For some, they are shocking, for others they appear to confirm what they feel they already know.

Objective facts prompt subjective responses - all of them informed by our individual lived experiences. We view ALL information we hear though our own unique viewpoints, understanding and experiences.
The possible reasons behind these apparent patterns in maternity care isn’t a topic for now (but for sure we can come back to it another time!). What may be helpful for now is to consider how these statistics make us feel and whether or not they prompt us to action.

I HEAR YOU. WHAT NOW?

If you find yourself concerned by the statistics or feel disheartened by the story they appear to be telling you about the care you may receive, I’d encourage you to seek out reliable information and support from sources you trust for yourself. Try to gain understanding about what factors may be influencing them and whether or not you feel they may impact your experience. Understanding the systems in which you are birthing can be empowering. By extension, asking your own questions and finding your own answers about those systems is a powerful tool for navigating pregnancy and preparing for birth. You could do this on your own or with the support of your birth partner(s), a doula or with your midwifery and/or obstetric care team. If you want to look at a more local level you can ask your local Trust for their maternity statistics which they should be able to provide for you.

If, on the other hand, these statistics feel unhelpful, or like an unwanted or intrusive addition to your experience then you do of course have the option to completely ignore them. Yup, completely. When we are given information, a common response is to feel the need to DO something with it. We can feel compelled to take action or to feel something. The implication being that the information you are being given should be important to you. But I’m here to suggest that you don’t have to. Just because these numbers exist and are published it does not mean that they need to influence or define your pregnancy and birth. You can continue to navigate your pregnancy and prepare for a birth which feels right for you in light of or in spite of these statistics.

The statistics exist. They help paint a picture. Or part of a picture at least.
Food for thought perhaps? Or maybe not. Your choice.
Much love

Becca
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