Audit in one unit found neonatal care to be suboptimal at weekends

EDITOR—Stewart et al reported that an excess of deaths related to intrapartum care occurred outside office hours.1 In a recent audit done over four months we found that routine neonatal care on our unit was suboptimal at weekends compared with weekdays. Altogether 760 (82.7%) of 919 women had their babies examined by a neonatal senior house officer before they were discharged by their obstetrician during weekdays, compared with only 150 (53.8%) of 279 women at weekends. Forty (14.3%) women had to wait between two and six hours for their babies to be examined at weekends, compared with 77 (8.4%) during the week. Our aim should be to deliver the same standard of neonatal care—both acute and non-acute—at all times. This may require increases in the numbers of senior house officers working in neonatal units at weekends. Alternatively, an extended role for midwives could include performing routine neonatal examinations. This would free neonatal senior house officers for acute neonatal care, especially at weekends.

Intrapartum death rates in England in 1993-5 did not show consistent peaks or troughs

EDITOR—We were concerned to read that babies born at night and during the summer in Wales are at increased risk of death due to intrapartum asphyxia.1 This suggests that staffing issues may be contributing to these losses.

We have examined the intrapartum death rates …