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Women still lack birth choices, warns midwife leader

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Too many women are still being denied choice when it comes to birth options, according to the head of the UK’s midwifery union.

Cathy Warwick, chief executive of the Royal College of Midwives, highlighted her concerns surrounding women’s choice in her opening speech to the RCM annual conference this morning.

“Remember it’s their pregnancy, their birth not ours”

Cathy Warwick

She said: “Despite the rhetoric, too many women are still denied a choice over fundamental issues, such as where they give birth. This is leaving many having a less than positive experience of pregnancy and birth.

“While it is encouraging that the number of alongside midwifery units has virtually doubled in the last five years, the same cannot be said for [fetal medicine units] and homebirths. Although there has been a modest increase in the number of freestanding birth centres, the proportion of women birthing in them has barely increased and the home birth rate continues to fall,” she said.

Her speech in Harrogate also covered themes including women-centred care, raising standards, safety and experience.

“England would go from being 3,500 midwives short to almost 5,000”

Cathy Warwick

Referring to the current midwife shortage in England, Professor Warwick noted that “for a generation” staff had “done the best they can… on a shoestring budget” but warned that the birth rate had begun to rise again and that Brexit posed a new threat.

“Here in England, we have well over a thousand NHS midwives who come from elsewhere in the European Union,” she said. “If the UK government decides they cannot stay, England would go from being 3,500 midwives short to almost 5,000.”

However, the RCM leader welcomed the government’s maternity safety action plan launched earlier this week by health secretary Jeremy Hunt.

The plan includes a maternity safety training fund of £8m and a £250,000 innovation fund for safety projects in maternity, and a new voluntary compensation scheme for families who suffered harm after maternity care failings.

Professor Warwick said: “If implemented it could have a significant and positive impact on the safety of England’s maternity services, and contribute towards better and safer care for mothers and babies.”

She also challenged midwives themselves to “make a difference” however they could, for example to “debrief the young newly qualified midwife who looks completely shell shocked at the end of a very busy shift or to smile as yet another woman arrives on the labour ward in strong labour and all the rooms are full”.

“Most importantly listen to the women and remember it’s their pregnancy, their birth not ours,” she told delegates.

“Your work is intensifying, that you struggle to take your breaks”

Cathy Warwick

But she highlighted that the health of midwives also needed attention, citing the RCM’s Caring for You campaign. At the core of the campaign, which was launched in June, is a call for NHS organisations to sign-up to the Caring for You Charter.

She said: “We know from our workplace representatives that your work is intensifying, that you struggle to take your breaks you should be entitled to and that you are working extra hours that are go unpaid.

“This is leading to more midwives and midwifery support workers feeling stressed and burnt out, to increases in sickness and turnover rates and that morale is suffering as a result,” she said.

“We cannot continue as we are, relying as we do on over-stretched teams of midwives and midwifery support workers to paper over the cracks,” she added.

Professor Warwick ended her speech by repeating a pledge that the RCM would challenge the pay review body to break the cap on pay awards, as previously reported by Nursing Times.

She said: “No more should money be wasted on agency and temporary staff when the same money could end the shortage of midwives by employing more.”


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