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Shift to midwife-led units plus HCAs could ease staff shortage

The growing number and complexity of births must be met with more training, more support workers and more midwife-led services, the Royal College of Midwives has said.

The RCM published its first “State of Maternity Services” report last week and plans to repeat the review annually. Services in England are “facing significant challenges with births rising by 22% since 2001”, according to the report.

Although the number of midwives has also increased, the RCM warns this has “failed to keep pace with the rocketing number and increasing complexity of births” and that the country needs 5,000 extra midwives.

Since 2001 there has been a 71% rise in births to women over 40, who are at higher risk of complications. There has also been a rise in births among other higher risk groups such as women with diabetes and other long term conditions. The average age of midwives is also rising, leading to fears of a retirement bubble.

The RCM made three proposals to address the midwife shortage. These include “providing more midwife-led units and more home births… [because] births in such units or at home result in fewer interventions and are therefore less demanding of midwife time” (see story above).

The report said: “For every 10,000 births moved from a consultant-led unit to a midwife led unit or to a home setting, the required midwifery workforce would be reduced by the equivalent of 71 full-time midwives.”

The report also recommended employing “adequately trained” maternity support workers to take on “up to 10% of the tasks traditionally carried out by a midwife”.

Finally the report recommends training more registered midwifes, in order to fill posts and replace those retiring.

Readers' comments (3)

  • michael stone

    Lots of things 'require more training', including that other aspiration of improving EoLC in the NHS, mentioned on NT at the moment.

    But why would anyone believe that more training willl be provided - everything I read, implies that there isn't 'enough' training provided at present, which the powers-that-be must be aware of: why should anyone expect that situation to improve ?

    Unsuitable or offensive?

  • Why is it suddenly wrong to want access to full medical facilities when having a baby?

    Unsuitable or offensive?

  • Latterlife Midwife

    Anonymous, 1:36pm: because in many cases, it is a waste of resources and raises the risk of interventional cascades. For women with low risk pregnancies and an adequate home environment/family support who are happy to get on with labour and birth without epidurals, birth centres and home births are beneficial to all. Please do some research on the subject because I'm not going to get into the extensive information available right now.

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