National Maternity and Perinatal Audit: Clinical report 2019. Based on births in NHS maternity services between 1 April 2016 and 31 March 2017

In the wake of national maternity and neonatal reviews and other improvement initiatives, changes are being implemented in the delivery of care to mothers and their babies in England, Scotland and Wales. Use of electronic records for maternity care is constantly developing, and provides a rich source of data to understand and evaluate these changes. The National Maternity and Perinatal Audit (NMPA) uses these data to produce information that can usefully support the improvement of maternity and perinatal care. This report presents measures of maternity and perinatal care based on births in English, Welsh and Scottish NHS services between 1 April 2016 and 31 March 2017. The report also provides contextual information describing the characteristics of women and babies cared for by NHS maternity services during this time period. The majority of the measures presented in this report are the same as presented in our previous report on 2015/16 data. One measure has been removed: early elective delivery without documented clinical indication. Four measures have been added. The first is birth without intervention, a composite measure to describe births that start and proceed spontaneously. The other new measures relate to babies admitted to a neonatal unit following birth: the proportions of term and late preterm babies who are admitted to a neonatal unit; the proportion of term babies who receive mechanical ventilation in the first 72 hours of life; and the proportion of babies who develop an encephalopathy in the first 72 hours of life. The results in this report are presented at trust/board level, rather than by site with an obstetric unit, as was the case for most measures in the previous report. This follows feedback from clinical services to the NMPA team,* and enables a more balanced inclusion of births in freestanding midwifery units and at home, as these can be included in trust level results but not as individual sites owing to low numbers.† The majority of trusts have a single obstetric unit and for those trusts this reporting change makes little difference. Site level results continue to be reported on the NMPA website.