The researchers wanted to know if maternal and foetal death figures were higher on weekends versus weekdays or during different months of the year. They analysed more than 45 million pregnancies between 2004 and 2014 to examine if there are significant differences in ratios of both maternal deaths and stillborn deliveries depending on the day they occurred. Lead author Dr. Steven Clark said:
“We were able to control for pregnancy complications, and found that most women with pregnancy complications known to lead to death actually deliver on weekdays, suggesting that the actual problem with weekend deliveries is even greater.”
Weekend delivery is associated with maternal and neonatal deaths, increased ratios of perineal cuts and tears, maternal transfusions, neonatal intensive care admissions, immediate neonatal ventilation requirements, neonatal seizures and antibiotic use.
Researchers also looked at months of the year including the ‘July phenomenon’ – the month of the year that is associated with an increased risk of medical errors and surgical complications that occur in association with the time of year in which medical school graduates begin their residencies. However, the study found no association between maternal-foetal mortality and the month in question. Dr. Clark continued:
“Any system that shows this sort of variation in the most important of all system outcomes is, by definition, badly broken. Our data suggest that a part of the overall dismal US obstetric performance may be related to this systems issue, that is, there may be a ‘spill over’ effect that is demonstrably worse on weekends but is also present on weekdays to a lesser extent.
Our data does not allow us to go any further than this in terms of specifying what the problem is. However, we believe it is likely due to the fact that rarely is care of the pregnant inpatient the primary concern of the treating doctor – it is almost always a distraction from office, surgery or personal activities.”
Hmm, strong words. Did you feel like you were a ‘distraction’ to your doctor? Do you think the day of the week or month of the year you give birth makes a difference to how you are treated in the Irish maternity system?
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