Response to BMJ Study on weekend birth outcomes
Dr Sarah McMullen, Head of Research, NCT
In November last year, a research paper was published in the British Medical Journal (BMJ) suggesting that there may be greater risks to baby and mother if births take place at the weekend1. This generated some really worrying press coverage, including stark messages about safety in news bulletins and sensationalist front covers across several daily papers. Since then, we’ve been concerned to hear of pregnant women who are worried about going into labour towards the end of the week or giving birth at the weekend, and that some women have been put off going to hospital at this time.
In fact, the conclusions were rather overstated in the press and many experts raised serious questions about the way it was reported, particularly considering the fear that it would inevitably cause amongst pregnant women at the time. What we do know is that there are very real risks to women and their babies if they don’t contact their community midwife or maternity unit if they have any concerns at the weekend. (You can read more about midwife care during pregnancy, labour and birth here.) This press coverage could cause harm if it affects women’s decisions about when to call or visit their maternity unit. It’s really important that we get this message out to expectant parents, and share constructive information about when women should seek support (e.g. Early Signs of Labour and Symptoms to Watch Out For).
Parents should be confident of receiving a high standard of care regardless of the day or time that they give birth. This study suggests that some complications are more likely to occur for mothers admitted and babies born at the weekend. However, what the study doesn’t do is tell us why these patterns in the data exist. Additionally, no consistent association between outcomes and staffing was identified. As the authors of the study themselves acknowledge, this research is based on limited data and more evidence is needed to draw robust conclusions about any possible link between the time of birth and outcomes for mother and baby. Individual women’s decisions about when to call or visit their maternity unit should not be influenced by this study.
Since the paper was published, there have been 36 rapid responses (as of 10/01/16) to the research paper on the BMJ website, questioning the conclusions of the research and the way in which it was reported. The response from the Royal College of Obstetricians and Gynecologists (RCOG) states that ‘this paper presents misleading evidence which will unnecessarily undermine the public’s confidence in maternity services’. There is also a response from the authors of the original paper addressing some of the concerns raised. You can read the original paper here, the responses to the paper here, and the full response from RCOG here.
We’re pleased to be involved in a National Institute for Health Research (NIHR)-funded study led by Professor Alison McFarlane, Professor of Perinatal Health at City University London. This study will use more reliable and detailed data sources to examine these patterns in more depth. You can read more about this study here.
For more information about pregnancy, birth and parenting visit our website: www.nct.org.uk
1 Palmer WL, Bottle A, Aylin P (2015). Association between day of delivery and obstetric outcomes: observational study. BMJ; 351: h5774.