Spontaneous labours in England fall as induced labours and caesareans rise
9 November 2017
NHS Digital must be quoted as the source of these figures
Regional data available in this report
The proportion of pregnant women having a spontaneous labour2 has decreased over the past year from 57.4 per cent in 2015-16 to 55.1 per cent in 2016-17. Over the same time, the proportion of caesareans undertaken before the onset of labour has increased from 14.7 per cent to 15.5 per cent and induced labours have increased from 27.9 per cent to 29.4 per cent, figures from NHS Digital show.
In 2006-07, the proportion of pregnant women having a spontaneous labour was 68.7 per cent, while caesareans undertaken before the onset of labour accounted for11.0 per cent of deliveries and induced labours for 20.3 per cent.
There was a total of 636,000 deliveries3 in NHS hospitals during 2016-17, a decrease of 1.8 per cent4 from 2015-16 (648,000).
NHS Maternity Statistics 2016-17 includes data relating to delivery and birth episodes and their booking appointments. For the first time, this publication examines data from Hospital Episode Statistics (HES)5 and experimental data from the Maternity Services Data Set (MSDS)6 with the aim of providing a more complete picture of NHS maternity activity.
Additional figures in the report from HES show:
Use of an anaesthetic or analgesic
The proportion of pregnant women who make use of anaesthetic or analgesics before or during delivery has increased slightly in the past year from 59.4 per cent in 2015-16 to 60.0 per cent of deliveries in 2016-17. The proportion of pregnant women who make use of anaesthetic or analgesics before or during is however lower than that seen in 2006-07 where it was 68.6 per cent
Additional analysis using experimental statistics from the MSDS, which account for 55.9 per cent of the deliveries reported in HES, show that7:
Skin to skin contact
In 2016-17, 80.0 per cent of women with babies born at 37 weeks gestation8 or more had skin-to-skin contact within one hour of birth9.
74.0 per cent of babies received breast milk (maternal or donor) for their first feed10.
11.6 per cent of women with a recorded smoking status at their booking appointment (which NICE recommends should ideally take place by 10 weeks into the pregnancy) were smokers.
Previously published official figures from the Smoking at Time of Delivery (SATOD) collection for 2016/17 show that 10.5 per cent of women were smokers12.
Data from the MSDS also shows the proportion of deliveries where the mother was recorded as a current smoker at the time of their booking appointment decreased with the mother's age. 29.7 per cent of women aged under 20 with a delivery in 2016-17 recorded in the MSDS were smokers at the time of their booking appointment. Among women aged 40 and over, only 6.2 per cent were smokers at their booking appointment.
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Notes to editors
1. NHS Digital is the national information and technology partner of the health and care system. Our team of information analysis, technology and project management experts create, deliver and manage the crucial digital systems, services, products and standards upon which health and care professionals depend. During the 2016-17 financial year, NHS Digital published 292 statistical reports. Our vision is to harness the power of information and technology to make health and care better.
2. Spontaneous labours are those that start spontaneously and end either in a spontaneous birth or one requiring intervention.
3. Counts of deliveries reported within HES are based on the number of unique delivery episodes. This is the hospital episode where a mother gives birth to a baby. The Office for National Statistics (ONS) collects information on births and maternities (maternities are broadly equivalent to deliveries in HES). Most of the information, for both live births and stillbirths, is supplied to registrars by one or both parents. It is legal requirement in England and Wales to register the identity of a new baby within 42 days of the birth. As it is a legal requirement to register all births, the ONS is the official source of delivery and birth information and should be used in preference to HES and MSDS maternity data held by NHS Digital for those data items reported to both NHS Digital and ONS data sets.
4. Numbers on deliveries shown are rounded to the nearest 1000. Percentage changes quoted between years have been calculated using unrounded figures.
5. Hospital Episode Statistics (HES) are compiled from data sent by NHS trusts in England and from independent sector organisations for activity commissioned by the English NHS.
6. The MSDS is a maturing, national-level dataset which has been impacted in terms of non-response from providers as they work towards establishing their reporting flows. In this case, for 2016-17 MSDS reported for 55.9 per cent of the number of deliveries reported in HES. Therefore, caution should be taken when interpreting the data at levels higher than individual providers. Because of this, no figures derived from the MSDS data are presented as England total figures; rather they are presented in terms of 'all providers who submitted data to the MSDS for the reporting period in question'. Statistics reported from the MSDS within the report are classified as experimental as these are new official statistics undergoing evaluation.
7. Data from HES and the MSDS shown are subject to different disclosure control rules therefore percentages shown using MSDS at sub national geographies are displayed to the nearest whole number.
8. A baby born at 37 weeks gestation or later is known as a 'term' baby. Babies born before 37 weeks gestation (preterm babies) may be less healthy and require additional care. Data at maternity service provider level are not influenced by the proportion of preterm babies that they deliver. This measure is produced only for term babies
9. The National Institute for Health and Care Excellence (NICE) recommends that mothers have skin to skin contact with their babies after birth to promote the initiationof breastfeeding and protect against the negative effects of mother-baby separation. Find out about NICE recommendations on skin-to-skin contact.
10. NHS Choices recommend that babies are breastfed in order to maximise the health benefits of breast milk, supporting babies' immune systems and promoting close and loving relationships. Visit NHS Choices for recommendations on breastfeeding.
11. Figures on smoking status shown relate to the time of the booking appointment which based on NICE recommendations should ideally take place before 10 weeks gestation age in the pregnancy. This is different to information reported within the Smoking at Time of Delivery (SATOD) data collection which is the official source of data for the proportion of women smoking at the time of delivery. This information is captured around 6 months after the time of the smoking status at booking appointment. Data published from SATOD is used within the Public Health Outcomes Framework and CCG Outcome Indicator Set and is used to monitor a number of existing national ambitions.
12. Published SATOD data for 2016/17 can be accessed via the following link https://digital.nhs.uk/catalogue/PUB24222 . In 2017/18 the methodology for how smoking prevalence was calculated within the SATOD statistical outputs changed to exclude maternities where the smoking status of the women was unknown. This resulted in slightly increasing the 2016/17 prevalence of women smoking at the time of delivery to 10.7%.
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