Maternity services policy: does the rhetoric match the reality?

The maternity services in England probably have one of the most comprehensive policy agendas of any maternity service in the world. The aim of this survey of service provision was to assess the extent to which policy reforms, national guidance for NHS care and recommendations of the Confidential Enquiries had been implemented in nine maternity units in the south of England. All the Trusts provided consultant-led care however only three Trusts provided a midwifery-led unit and, although all Trusts offered home birth as an option, in three Trusts this depended on midwifery staffing levels. All nine Trusts reported having a diabetic clinic but only two Trusts offered a specific psychiatric maternity clinic. Apart from specific ‘skills drills’ sessions there was ad hoc provision of ongoing staff development.