Labour pains

There are mitigating factors. High levels of immigration to and mobility within London present particular challenges. And high living costs make retaining the best staff more difficult here than elsewhere. But some of the most stinging criticism relates to poor hospital hygiene: inexcusable in any ward but both dangerous and demoralising in maternity units. Then there is the high rate of caesareans - inadequate prenatal checks lead to higher levels of emergency interventions.

The primary reason for poor maternity care is inadequate staffing, with a significantly poorer ratio of midwives to deliveries in the worst-performing trusts. Alan Johnson, the Health Secretary, has promised £122 million extra for maternity services in the next three years - bolstering existing promises to extend maternity choice by 2009. New mothers will be the judges of whether that money is well spent.