Women are travelling further in pregnancy and labour to access care
High proportions of unplanned out-of-hospital births, which carry very high neonatal mortality rate of 6 per 1,000
Higher rates of social induction and "elective" Caesarean operations, placing women and babies at greater risk of damage from medical procedures
Greater need for epidural anaesthesia, which increases the risk of Caesarean section, forceps and vacuum delivery
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The rationalisation of scarce hospital resources through active management
Reduced levels of postnatal care, with women being discharged from hospital within 48 hours of giving birth