Substandard obstetric care leads to much greater risk to baby

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A study published this week in the British Journal of Obstetrics & Gynaecology has found that infants of women who received substandard care * during labour had a three-fold increased risk of asphyxia (little or no oxygen in the blood) at birth.

Asphyxia results from an inadequate supply of oxygen to the baby during labour and delivery. Although relatively rare, it can lead to catastrophic brain injury and/or death for baby.

“In this study, researchers sought to investigate the result of substandard care during labour and delivery on infant outcome. The researchers found that if there was substandard care during labour, the risk was three-fold that the infant would have asphyxia.

The main reasons for substandard care were related to misinterpretation of CTG**, not acting on an abnormal CTG in a timely fashion, and misuse of oxytocin***. In cases of traumatic instrumental deliveries, the risk that the infant would have asphyxia was almost 18-fold.”

While the data relates to deliveries in Sweden, there is reason to believe things are no better (and possibly worse) in the UK . According to the World Health Organisation’s data, infant deaths in the UK are nearly twice those of Sweden. For maternal deaths in childbirth, the UK ‘s rates are nearly four times those of Sweden.

“The results emphasize the importance of reacting promptly to signs of asphyxia. The authors call for educational efforts among physicians and midwives to improve CTG interpretation and fetal surveillance. Lead author, Dr Sophie Berglund, from the Karolinska Institute in Stockholm, Sweden, said “There was substandard care during labour in two thirds of infants born with signs of asphyxia.”


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