This book is all about improving the quality of care in maternity services. The individual chapters reflect the fact that the main drivers for improvement are clinical effectiveness and increasing patient expectations. In each area of practice described, there is recognition that the appropriate clinical response to these drivers is service organisation. This book will help clinicians to take responsibility not only for managing individual patient conditions but also for developing services that meet patients' needs. Clinical developments will only come about if clinicians take the initiative to ensure that improvements happen. This book demonstrates that much can be achieved within current resources and without the need for major additional expense. Different approaches are demonstrated but the key issue is the patient pathway, with the underlying philosophy of continuous improvement in quality. Clinical leadership is the key to success. There is increasing evidence that obstetricians and gynaecologists are more than equal to the task and recognise the satisfaction that derives from being associated with clinical development and improvements in the quality of care for women. Trainees, clinicians, managers and commissioners of services will find this book of practical value and there should be a copy on the shelves of every hospital obstetric unit.