'A time to be born'?

Background, including element of originalityIt has long been established that numbers of spontaneous births varied by time of day and were higher at night than during the day. The extent to which the rise in obstetric... [ view full abstract ]

Background, including element of originality

It has long been established that numbers of spontaneous births varied by time of day and were higher at night than during the day. The extent to which the rise in obstetric intervention has modified this pattern has not so far been documented at a national level in England and Wales, as national data about the time of day of birth were not available before 2005.

Method

In a previous project, data recorded when a baby’s birth is registered by parents were linked to the data recorded when a birth is notified to the NHS, including the time of birth. These previously linked data about births from 2005 to 2014 were now linked to data about care at birth recorded in the Hospital Episode Statistics for England and corresponding data for Wales. Births were analysed by hour of the day and day of the week subdivided by gestational age, onset of labour and mode of birth.

Results

About half of the singleton births in England occurred spontaneously after spontaneous onset of labour. Their numbers were highest between 1am and 7am and peaked around 4am. For other births following spontaneous onset of labour, instrumental births were more likely to occur between 9am and 5pm and emergency caesareans were more likely between 9am and midnight. Births following induced labours peaked around midnight, regardless of mode of birth. In contrast, the majority of planned caesareans occurred between 9am and noon.

Discussion

These patterns have implications for the staffing of maternity units and parents’ experiences of birth. Although some births can be scheduled to take place in day time hours, the extent to which this happens reflects levels of obstetric intervention and possibly other factors.

Conclusion

Maternity services need to ensure appropriate staffing at all times. Although many operative births can be scheduled for day time hours, spontaneous births and births following induction still peak at night.