Changes in access to antenatal services

All pregnant women should be encouraged to access maternity services for a full assessment of their health and social care needs, risks and choices within the first 12 weeks of their pregnancy. This is to give them the full benefit of personalised maternity care, and to improve outcomes and experience.

How have rates of timely antenatal assessments changed?

The ratio of women who had their first antenatal assessment before 12 weeks and six days has generally increased over time, from 2009/10 Q3 (87%) to 2014/15 Q3 (102%). For details on how this ratio can be higher than 100% please see 'about this data' at the bottom of this page.

How has the number of timely antenatal assessments changed?

The total number of maternities was broadly steady (despite seasonal fluctuations) between 20010/10 Q1 to 2012/13 Q1, with an average of 166,000 maternities in each quarter. However, from 2012/13 Q1 onwards this has dipped and since then there was an average of 156,000 maternities in each quarter - a decrease of 10,000. Generally, the number of assessments happening before 12 weeks and six days was similar in these two periods with an average number of 152,000 assessments in both. This suggests that the increase in performance seen in chart 1 may be in part due to the decrease in number of maternities over time.

What proportion of antenatal assessments happened after 12 weeks and 6 days?

The proportion of all assessments happening after 12 weeks and 6 months had been decreasing over time, from a peak of 20% in 2009/10 Q4 to a low of 13% in 2012/13 Q3. However, since then the proportion has increased again and was 17% in 2014/15 Q3. The relationship between the number of assessments and the proportion happening after 12 weeks and 6 days is not clear cut. It does not appear that an increase in the proportion of assessments happening later is related to an overall higher volume of assessments.

About this data

From 2009 to the end of 2011, antenatal appointment data were collected as 'vital signs'. From 2011 to the end of 2012, these data were collected as 'integrated performance measures monitoring'.

Since April 2013, data has been provided by NHS England in its 'Maternity and Breastfeeding data set'. The number of pregnant women having an assessment is taken from provider data and the number of pregnant women eligible is taken from ONS national statistics on the number of live births.

Data are only available geographically, no other details (such as age, ethnicity, etc) are collected. Data are given in three quarter outputs. If a woman is assessed in quarter 1, she is recorded as giving birth in quarter 3, so although data were collected from 2011/12 quarter 4, results are only available from 2012/13 quarter 2 onwards. Results are recorded to correspond to the quarter the antenatal appointment occurred in, not when the maternity was recorded.

Note that percentages can be more than 100% if women who are assessed go on to miscarry or terminate, causing them to be captured in the numerator but not the denominator. This could also occur if women deliver at a different hospital to where they were assessed.

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