Maternity reviews: we know what needs to change

Borland asks what needs to change after the Amos review of maternity care in England.1 She notes that all maternity reviews in the past 11 years have found similar themes. All the hospitals reviewed work in the same maternity system. Every system is perfectly designed to produce the results it gets.Birth is a physiological but imperfect process that sometimes requires medical intervention when the birth process becomes life threatening. The need for medical intervention is even greater now because of an increasingly complex maternal population. This rise has coincided with a system-wide attempt to reduce interventions by increasing physiological births. The effect has been the inadvertent reduction in the clinical supply of lifesaving interventions at a time of increasing demand for interventions from the birthing population. This has created an intervention gap, which has denied mothers and babies lifesaving interventions and caused avoidable harm.Given such an obvious cause of harm,…