By Matthew Hill BBC Health Correspondent

Childbirth can be hazardous

Senior doctors from maternity units across the UK were surveyed by BBC Radio 4's File on Four programme.

About 280 patients suffered in the last year due to consultant shortages, according to doctors who replied to the survey of members of the Royal College of Obstetricians and Gynaecologists.

Of more than 700 consultants who responded, half admitted the standard of care on their wards was less safe in the early hours of the morning than in the evening.

We really have to push hard for a senior consultant presence on wards 24 hours a day in big units Maggie Blott

Maggie Blott, a consultant at King's College Hospital, London, who represents the Royal College, said: "Several studies have now shown that sub-standard care in labour has contributed to poor outcomes, and the deaths of babies and mothers.

"This is mainly because of failure to recognise a problem, failure to act on a problem, poor communication, and failure to contact senior staff.

"I think we really have to push hard for a senior consultant presence on wards 24 hours a day in big units."

Ms Blott said part of the problem was that it was very difficult to predict problems with childbirth.

"I can be sitting on my labour ward drinking a cup of coffee, and the next minute there can be a catastrophic problem such as a difficulty delivering a baby that needs immediate action."

Health Minister Jacqui Smith said an extra 470 trained specialists would be available to take up posts by 2004.

"I would not want women going away with the impression that they are not safe in the NHS," she said.

Guidelines 'not met'

"They are as safe as they can be but we are working to make sure they are even safer."

However, the NHS litigation authority is concerned about the mounting clinical negligence bill over childbirth which currently stands at �3.5bn.

The authority has given hospitals guidelines for consultant cover which are designed to reduce this risk.

But half of those who replied who work in the largest units said their hospital did not meet them.

Until they do, hospitals will be paying higher insurance premiums - and mothers and babies will continue to be at risk.

Recent studies have shown women and their babies are more likely to die during labour in the NHS because of major medical blunders than women in other European countries.