One of the biggest decisions you have to make when having a baby is which hospital or birth unit to entrust yourself to.
It's a hard choice to make if you've no previous experience and live in an area where there are several hospitals or maternity units.
A survey of maternity services carried out by the Healthcare Commission and published in January 2008 found significant variations in the quality of care offered across England and Wales.
The Commission ranked 22% of maternity services as ' fair performing' (32 NHS trusts), 21% as 'least well performing' (31 trusts), 26% as 'best performing' (38 trusts) and 32% 'better performing' (47 trusts).
What does all this mean for maternity services in your area?
Regionally, NHS trusts in the north-east of England performed better than others. Seven of the eight trusts in this area were rated as 'best performing'.
Trusts in London came bottom of the class: 19 out of the capital's 27 trusts were rated as 'least well performing'. Reasons for this could include staffing levels, women's expectations and factors such as the high mobility of people moving in and out of catchment areas.
There was no evidence that smaller hospitals perform better than larger ones or vice versa.
Factors taken into consideration during the review included clinical care, access to antenatal care, availability of scans and screening tests, choices in labour (eg pain relief), delivery room facilities, C-section statistics and post-natal care for mum and baby.
So what happens if your local maternity unit appears to score badly?
The Healthcare Commission review is not a system of recommendation; a score of 'least well performing' does not mean your local maternity unit is unsafe.
Sue Eardley, Maternity Services Project Lead at the Healthcare Commission, says, 'It's important for expectant mothers and their partners to know that if a trust is rated as 'least well performing', it does not mean that a service is unsafe.
'If we believed any unit to be unsafe, we would take immediate action to ensure mothers and babies were protected.'
But you should take the time to assess services provided by your local unit, using the results of the Commission's review to help improve the quality of your own care.
For example, if the review shows your trust is weak in offering information to mums-to-be about antenatal tests and screening, make sure you ask your midwives to explain the reasons for the different tests available.
Trusts reported differing rates of breastfeeding. The highest performing stated that 78%+ of new mums managed to establish breastfeeding, while at the other end of the scale, a quarter of NHS trusts put breastfeeding rates at 58% or less.
If you intend to breastfeed but are worried you won't get the right support from your maternity unit, do some research in advance. Find out who to contact about breastfeeding support and speak to them before the birth if possible.
Empowering yourself about the services provided by your local NHS trust, where to get them and how to ensure you get the birth experience you want will enable you to get the best out of your local unit.
