Janice McNichol, operation services manager for obstetrics and gynaecology, takes us through the history of maternity services within the NHS

Jul 4 2008 by Karen Wilson, The Journal

SINCE the beginning of the NHS in 1948 there has been a total transition in maternity services and we’ve come full circle in the last 60 years.

Historically the majority of women delivered their babies in their own homes with the aid of a community midwife, and possibly their GP. Only those that had a problem during pregnancy came into hospital. Births were not without their risks and many women suffered complications during childbirth.

Over the years more and more women came into hospital to have their baby and before long this became the norm. Now the service is much more patient-led and women have a number of options within the trust. We have both medically-led and midwife-led maternity units, a birthing pool if women want a water birth, or they can choose to have a home birth.

We encourage mums-to-be to keep on their feet as long as possible during labour and have recently purchased some Febromed equipment, which allows the woman and her partner to adopt different positions in labour to assist the birth. Pain relief methods in labour have also advanced over the years. There is now a range of options for women to choose from should they need to use pain relief, but evidence suggests that one-to one support during labour from a midwife greatly reduces the level of pain relief that women may need.

While ante-natal care was predominantly carried out within the hospitals when the NHS began, now it is very much community- based for low-risk women. Teams of midwives work closely with GPs, consultants, health visitors, physiotherapists, ultrasonographers and other healthcare professionals to provide an excellent all-round service. The mother’s care is overseen largely by their community midwife at GP surgeries with ante-natal and post-natal drop-ins for additional support. Some services are now offered at community centres such as Sure Start, and children’s centres which are based in the local communities.

Women in the 1940s would not have had lots of the options now available to today’s pregnant woman.

All women are now offered ante- natal screening tests to detect abnormalities throughout various stages of their pregnancies. These screening tests began routinely being offered in the 1980s and scanning began in the mid-70s. These major advances in the provision of maternity services have helped to reduce the maternal and neonatal infant mortality and morbidity rates to today’s very low levels. Maternity care in the NHS has come a long way since 1948 in terms of the options and services available to women which is why Northumbria Healthcare has been rated by the Healthcare Commission as the fifth best provider of maternity services in the country.

The service is much more patient-led and women have a number of options within the trust