Achieving sustainable quality in maternity services - using audit of @entity322 and XXXX to identify shortfalls in meeting standards.

@entity1 @entity546 @entity322
BACKGROUND: Some complications of childbirth (for example, @entity322 ) are a source of social embarrassment for @entity1 , and are often under reported. Therefore, it was felt important to determine levels of complications (against established standards) and to consider obstetric measures aimed at reducing them. METHODS: Clinical information was collected on 1036 primiparous @entity1 delivering at North and South Staffordshire Acute and Community Trusts over a 5-month period in 1997. A questionnaire was sent to 970 @entity1 which included self-assessment of levels of @entity322 and @entity546 prior to pregnancy, at 6 weeks post delivery and 9 to 14 months post delivery. RESULTS: The response rate was 48%(470/970). Relatively high levels of obstetric interventions were found. In addition, the rates of instrumental deliveries differed between the two hospitals. The highest rates of postnatal symptoms had occurred at 6 weeks, but for many @entity1 problems were still present at the time of the survey. At 9-14 months high rates of @entity546 (29%(102/347)) and @entity322 (35%(133/382)) were reported. Seventeen @entity1 (4%) complained of @entity322 at this time. Similar rates of @entity322 and @entity546 were seen regardless of mode of delivery. CONCLUSION: Further work should be undertaken to reduce the obstetric interventions, especially instrumental deliveries. Improvements in a number of areas of care should be undertaken, including improved @entity1 information, improved professional communication and improved professional recognition and management of third degree tears. It is likely that these measures would lead to a reduction in @entity322 and @entity546 after childbirth.
