Some trends are apparent but the data still have too many gaps

After a long gestation the Department of Health has finally delivered a bulletin on maternity statistics.1 Few routine data on maternity care in England have been published since 1985, the last year of the old Hospital In-patient Enquiry. This lack has been equally frustrating to people who want to compare local performance with national statistics and those who want to monitor national trends. 2 3 Not surprisingly, the new statistics show many changes in maternity care since 1985, while revealing inadequacies in the data.

The Maternity Hospital Episode Statistics system,4 through which the data are collected, started in April 1989, and the new publication contains data for 1994-5 and trends since 1989-90. It is restricted to data about care during delivery, but a further bulletin with data for 1995-6 and 1996-97, including antenatal and postnatal episodes and data about newborn babies, is promised for the autumn. Subsequent bulletins will then appear annually.

The most dramatic changes are in caesarean section rates and the methods of operative vaginal deliveries (see figure). The caesarean section rate, which levelled off at just above 10% of …