Timing of singleton births by onset of labour and mode of birth in NHS maternity units in England, 2005–2014: A study of linked birth registration, birth notification, and hospital episode data

Abstract

BackgroundMaternity care has to be available 24 hours a day, seven days a week. It is known that obstetric intervention can influence the time of birth, but no previous analysis at a national level in England has yet investigated in detail the ways in which the day and time of birth varies by onset of labour and mode of giving birth.MethodWe linked data from birth registration, birth notification, and Maternity Hospital Episode Statistics and analysed 5,093,615 singleton births in NHS maternity units in England from 2005 to 2014. We used descriptive statistics and negative binomial regression models with harmonic terms to establish how patterns of timing of birth vary by onset of labour, mode of giving birth and gestational age.ResultsThe timing of birth by time of day and day of the week varies considerably by onset of labour and mode of birth. Spontaneous births after spontaneous onset are more likely to occur between midnight and 6am than at other times of day, and are also slightly more likely on weekdays than at weekends and on public holidays. Elective caesarean births are concentrated onto weekday mornings. Births after induced labours are more likely to occur at hours around midnight on Tuesdays to Saturdays and on days before a public holiday period, than on Sundays, Mondays and during or just after a public holiday.ConclusionThe timing of births varies by onset of labour and mode of birth and these patterns have implications for midwifery and medical staffing. Further research is needed to understand the processes behind these findings.

Births and their outcomes by time, day and year: a retrospective birth cohort data linkage study

“…Several articles have now been published in peer-reviewed journals. [157][158][159] Publication, which puts the methodology and results in the public domain, allows the results to be shared with the wider public.…”

“…Now that the results have been published, a telephone journal club discussion is being arranged. 159 NCT may also be able to incorporate the findings into conference presentations and talks to policy-makers and professionals, such as the All Party Parliamentary Group on Maternity, which was set up with the support of NCT, and continues to be serviced by NCT. All dissemination activities will be enhanced and reach a wider audience with the use of social media such as Facebook and Twitter.…”

“…One article describing the timing of singleton births in NHS maternity units in England has now been published. 159 The second, focusing on home births and other births outside NHS maternity units was initially rejected but will be resubmitted following the journal's suggestions.…”

Involving service users in Births and their outcomes: a retrospective birth cohort data linkage study analysing daily, weekly and yearly cycles and their implications for the NHS

“…Together they wrote the section on health policy context in the introduction for the final report as well as the chapter and appendix on PI&E, and were fully involved in reviewing and commenting on the whole report [ 1 ]. They had input into all articles and poster presentations resulting from the project and were particularly involved in a paper on onset of labour and mode of birth [ 84 ]. MS contributed the initial ideas for analysis of timing in relation to mode of birth, based on her long experience of analysing maternity data from the perspective of pregnant women, and MN contributed to the writing of the paper, using the idea of intrapartum (labour and birth) ‘care pathways’ as the basis for describing the analysis [ 84 ].…”

Cohort profile: the eLIXIR Partnership—a maternity–child data linkage for life course research in South London, UK

“…14 Several linkages of clinical maternity and infant data have nonetheless shown the feasibility of the approach and usefulness, for example, in aligning hospital maternity data with national birth registration datasets, or birth registration datasets with Hospital Episode Statistics (HES), or using UK primary care pregnancy data to create a pregnancy register. [15][16][17][18][19][20][21][22][23][24][25] It is well established that maternal physical and mental well-being in pregnancy and the postpartum period can strongly influence the neonatal outcome and the physical and mental health of the child. [26][27][28][29] To our knowledge, no clinical data linkages in maternity or neonatal services have to date incorporated clinical information from maternity, neonatal and mental health services into a single continuum to interrogate these associations at a population level.…”