exposes substandard NHS care
200 babies are dying each year and thousands of women
suffering pain following childbirth, because doctors in
maternity wards are still using outdated practices.
study by obstetrics and gynaecology researcher Dr Jim
Thornton and colleagues at Leeds, York and Birmingham
has found that despite clear scientific evidence showing
best practice, many units had no systematic procedures
for ensuring that guidelines were followed.
study looked at cases from 1988 and 1996 in 20 maternity
units to determine changes in practice. All cases involved
four situations where a particular treatment was recommended.
Jim Thornton explains: "We found a dramatic rise in the
level of compliance, showing that obstetricians and midwives
have altered their practice in response to evidence. However,
adherence rates are still below 100 percent in many units,
and in some units considerably below. As a result, large
numbers of women and babies are receiving substandard
care in the NHS."
study estimates that each year 2,000 women suffer wound
infections following Caesareans, 200 premature babies
die, nearly 8,000 women are left in pain from catgut sutures
and there are 1,500 cases of severe maternal trauma from
forceps deliveries, and all of these are easily preventable
if proper guidelines were followed.
guidelines were followed, the study found it was due to
key enthusiastic staff, or access to the Cochrane database
which reviews the results of clinical trials to help doctors
keep up to date with new findings (for more information
on Leeds' involvement in the Cochrane collaboration, see
Thornton: "Our study shows that clinicians do respond
to the evidence, albeit imperfectly. Clearly there remains
substantial room for improvement."
study will be published in June in the International
Journal for Quality in Health Care.