The Good Birth Guide is a Health programme.

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The Good Birth Guide

The Good Birth Guide reveals for the first time the astonishing variation in treatment offered to women giving birth in this country. While there are examples of best practice, for too many women today birth in Britain is a dissatisfactory and distressing experience.

For the last year researchers from a company called Dr Foster and London's Imperial College have been gathering data on Britain's maternity services. The research was conducted in consultation with the Department of Health, the Royal College of Midwives and the National Childbirth Trust. The Royal College of Obstetricians and Gynaecologists are amongst the other professional bodies that also gave advice. Dr Foster's work reveals the changing face of childbirth. They've found huge regional variations in clinical procedures, potentially unsafe staff shortages in key areas, and clear evidence that it's doctors not mothers that are taking decisions.

In particular the research reveals a disturbing rise in the rates of Caesarean births. Most sections are carried out when obstetricians believe that a normal delivery carries a significant degree of risk to the health of the mother or the baby. The factors can include everything from maternal age to foetal distress during a long labour or when a baby is breach. But that doesn't explain why caesareans are on the increase. There are two theories. Firstly that caesareans provide a safer alternative for doctors. Secondly, birth in a painful and potentially damaging process that some women would prefer to avoid - sometimes described as the "too posh to push" factor.

Rebecca Lathe had a Caesarean four months ago and still hasn't got over it. She was pregnant with her second baby. It was breach but she and her husband wanted to try and have a natural birth, but her consultant felt the safest course for her and her baby was a Caesarean. "We felt quite powerless. We felt that we'd stepped on to this moving walkway and we were going straight through the theatre door..."

But that variation in procedures is not just confined to Caesarean sections. There are around 280 district general hospitals in the UK, each with its own approach to treatment, so whether you have an epidural, episiotomy or water birth depends on where you give birth. As a consequence of this lottery some women may be given no choice or control over the birth they want while others have a much more positive experience.

Despite complications, Anne Edmondson was happy about the birth of her child because she felt fully informed and had a wide range of options open to her. She planned to deliver in a local midwife-led community hospital with a minimum of medical intervention. In the end things didn't go as planned. "I was induced at 37 weeks because there was a worry that I might develop pre-eclampsia. Even though it's not what I wanted I'm not too disappointed. In the end what you want to choose has got to take second place to what you know to be the safest thing to do."

The data will be available on the Dr Foster website after the transmission of the programme.

Producer : Diarmuid Jeffrey

Production Company : Dual Purpose

Genre: Health

Running Time: 60 minutes (approx)