Maternity care failings highlighted

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Guidelines from the National Institute for Health and Clinical Excellence (Nice) recommend 11 checks to be performed during ultrasound scans.

These include studying the baby's heart function, length of spine, counting bones in the arms and legs and looking at head shape and size. The scans should also examine the development of the baby's face and lips.

But a report from the Healthcare Commission found that just 61% of scans performed by trusts included all 11 checks.

Nice also raised the quality requirements for Down's syndrome screening in April 2007, but only 11% of trusts reported meeting these standards for all women. This means those women in the remainder of cases are receiving inferior screening, according to the Commission.

The study also suggested a link between low staffing levels on maternity wards and overall poor performance by units. On average, units have 31 midwives per 1,000 deliveries but nine trusts trusts had only 26 midwives per 1,000 deliveries or fewer.

Two thirds of these trusts were scored weak in the review, suggesting very low staffing levels may be associated with poor overall performance, according to the report.

The Royal Colleges recommend 36 midwives per 1,000 deliveries to enable one to one care in labour.

A total of 68% of trusts were meeting a guideline set by the Royal College of Obstetricians and Gynaecologists requiring consultants to be present on the labour ward for at least 40 hours per week.

However, a third (32%) were not yet meeting the guideline, according to the study.