Trolley 546

Trolley 546 was captured just outside the Sainsbury's Kiln Lane estate, so just qualifying. A rather wet morning but the car park was still busy. While, contrary to recent experience, there were plenty of other small trolleys in the stacks outside the main entrance.

Home to read in my email the apparently bad news at reference 2 about maternity performance in this country relative to that in other countries in Europe, with maternal death rates around four times higher in the UK and in Slovakia than in the best performers. Noting that performance still pretty good by the standards of the world at large. And, digging a bit deeper into reference 3, the UK performance on this particular measure is not that different, albeit somewhat higher, than that of the other large countries in the study, in particular France and Italy. And the best country, Norway, is very rich. They should be able to afford to do well.

Furthermore, the whole story seems to be rather more complicated than a quick reading of reference 2 would suggest, never mind the title of the piece. I have not included the extensive notes to the graphic above, lifted from reference 3, but there is still enough left to show large variations in data collection across these eight countries. Against which the caution conclusion of reference 3 seems appropriate: 'variations in maternal mortality ratios exist between high income European countries with enhanced surveillance systems. In-depth analyses of differences in the quality of care and health system performance at national levels are needed to reduce maternal mortality further by learning from best practices and each other. Cardiovascular diseases and mental health in women during and after pregnancy must be prioritised in all countries'. That said, deaths from something called 'venous thrombosis and thromboembolism' do appear to be high in the UK, as do those by suicide and those from substance abuse.

Less surprising - if depressing - was the fact that being foreign born or even just foreign was a big risk factor in most of the countries looked at.

Reference 2 also draws on the reports from UK and Ireland, one very short and one rather long, to be found at reference 4. The story there seems to be that things got a lot worse in the period 2018-2020 compared with 2017-2019 - with the more recent period including COVID disruption to health services generally. Given this last, it is not clear to me that maternity services have fared worse than other parts of our health service. The answer being, as always, that more money is needed, not more privatisation.

All in all, further evidence, if any were needed, that statistics is tricky and that their reduction to a three-minute read is often more difficult than might at first appear.

References 

Reference 1: https://psmv5.blogspot.com/2022/11/trolley-545.html.

Reference 2: Mothers in UK Have Fourfold Risk of Death After Giving Birth - Sheena Meredith, Medscape - 2022. A piece which draws first on reference 3 and second on reference 4.

Reference 3: Maternal mortality in eight European countries with enhanced surveillance systems: descriptive population based study - Catherine Deneux-Tharaux and others - 2022. A European effort. Open access at https://www.bmj.com/content/379/bmj-2022-070621.

Reference 4: https://www.npeu.ox.ac.uk/mbrrace-uk/reports.

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