This report presents findings from almost 600,000 singleton births in NHS maternity services across England, Scotland and Wales during 2024 – highlighting inequalities in timely access to maternity care and changing patterns of birth. It examines key measures of maternity care and outcomes, identifies national trends and variation, and makes recommendations to support quality improvement across maternity services.
Local level initiatives and campaigns targeted at improving rates of timely pregnancy booking should be co-designed with groups and communities most likely to receive care after 10 weeks to ensure their needs are met
The report identifies timely access to maternity care as a key priority. Nearly one in four women and birthing people (24.4%) had their first maternity booking appointment after 10 weeks’ gestation, despite national guidance recommending booking by 10 weeks. New analyses highlight important inequalities, with substantially higher rates of late booking among Black and Asian women and birthing people, and those living in the most deprived areas. The report recommends that commissioners, maternity networks and local communities work together to understand and address barriers to early access to care.
It also highlights continuing changes in patterns of birth, with vaginal births becoming less common and caesarean births increasing over the past decade. The audit notes that these changes have important implications for maternity workforce planning, theatre capacity and service resources, and recommends that local maternity networks use their own data on maternal characteristics and mode of birth to inform future service planning.
The audit reports encouraging progress in reducing the proportion of babies who are small for gestational age (SGA) and born at or after their due date, particularly in England. This may reflect improvements in antenatal monitoring and national initiatives to identify babies at risk of growth restriction. The report recommends that maternity services continue to review policies for detecting and managing fetal growth restriction and promote shared learning across services to support further improvement.
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