THE FUTURE OF THE MATERNITY SERVICES.

W. Dunlop.

Maternity units are closing in substantial numbers. There does not appear to be a clear strategy underpinning this change. Nevertheless, it is clear that new models of maternity care are being introduced, often without preliminary evaluation. Documentation of these widespread changes is poor, mainly because of haphazard collection of data.

Factors influencing this process include changes in provision of medical and midwifery staff, attempts to improve the quality of care, presumed cost benefits, perceived expectations of the women and their families and the need to implement the Government report "Changing Childbirth." However, there are significant deficiencies in our information in several of these areas and in consequence some changes are being implemented on the basis of assumptions rather than evidence.

A multidisciplinary working party was set up at the invitation of the previous Secretary of State for Health with the task of providing advice about the reconfiguration of maternity services. It is anticipated that their report will be published very soon. Aspects of the document which are already in the public domain will be discussed during this presentation. The extent and nature of change in the maternity services will be explored, and areas where anticipated change has not occurred will also be described. Opportunities for future development will be suggested and the audience will be invited to comment on how to influence and assess change in the future.