Watchdogs say the department at Watford General Hospital is one of the 'least well performing' with testing and screening, safety and training all scoring poorly.

West Herts Hospitals NHS Trust also did badly for the provision of antenatal classes, which were axed in 2006 and reinstated last September, staffing and the use of caesarean sections.

Maternity services were shut at Hemel Hempstead Hospital in 2002 and the low-risk birthing unit closed at the end of 2005.

Since then mums have been forced to go to Watford, where there have been complaints about overcrowding and overworked midwives.

Zena Bullmore, chairman of Dacorum Hospital Action Group, said: "It's not the fault of the midwives - it's the fault of the constant overcrowding at Watford.

"The birth rate is going up. We didn't have enough facilities before and by closing them at Hemel they made things worse, not better."

The research, involving a number of indicators, was carried out by the Healthcare Commission into every maternity unit in the country.

Chief executive Anna Walker said: "There have been serious concerns about maternity services.

"That is why we have carried out a wide-ranging review. We have assessed 148 trusts providing maternity services against a comprehensive range of issues that women and clinicians tell us are important.

"The care given to women during pregnancy, birth and the time just after giving birth is extremely important to both the mother and the baby.

"It can have lasting negative effects if not handled correctly."

She added: "Those trusts that were least-well performing should as a matter of urgency take steps to improve and we shall be checking that they do so."

Lib Dem County Councillor Nick Hollinghurst said he would be pushing the county's health scrutiny committee, of which he is a member, to review maternity services.

"Once again the West Herts Hospitals Trust gets a poor rating. This time it is for maternity services.

"These days mothers are supposed to have a choice as to where and how they have their baby delivered.

"But where is the choice round here? Hertfordshire mothers are marooned on an island of poor performance. It's a shame and a disgrace!"

In a statement the trust said its mortality rate – at less than one death per thousand births compared with a national average of one in 300 – was among the lowest in the country.

Chief executive Jan Filochowski said: "We have responded quickly to the Healthcare Commission's findings, and have improved our services and taken action to ensure all women have a positive experience.

"For example, we have recruited 18 new midwives, introduced multidisciplinary training and now provide a wide range of education programmes for parents, including evening and weekend courses."

The trust said it put in place an action plan to increase the number of midwives and consultants, improve information for mums and partners, and cut the number of caesarean sections.

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