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Baby deaths could have been avoided

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More than half of baby deaths at a number of West Midlands hospitals could have been avoided if the mothers had been better assessed for risk factors, and one quarter of the deaths would ‘probably’ have been avoided, a study has found.

The research, carried out by the West Midlands Perinatal Institute, found community midwives working on the patch had 50% higher caseloads than the recommended level, even though they were working five extra hours each per week.

The review of 94 baby deaths across six maternity units in 2008-9 found that of 65 normally-formed babies, 19 possibly could have avoided death, and 16 probably would have avoided death if they had received better care.

The WMPI, which covers five primary care trust areas, found poor initial assessments at booking by midwives meant that risk factors were often not identified.

The report also identified “substandard care” in: antenatal surveillance; communication with the mother; postnatal follow-up and support; and development of management plans.

The Institute surveyed community midwives working across the maternity units at the time, and found their average caseload at the time was 146, compared to the Royal College of Midwives recommended number of 98.

The midwives said they worked five hours on top of their contracted hours each week, on average, they said the quality and quantity of their antenatal and postnatal visits were affected by their lack of time, and one third of midwives were so dissatisfied they said they were considering leaving.

The report’s findings linked the avoidable deaths to social deprivation among mothers, with complex social factors adding to the need for good initial assessments.

The report recommended more community midwives to reduce caseloads, more training around social need, improved hand-held maternity records, and community-based ultrasound services.

Perinatal Institutute director Jason Gardosi said some of these changes had already reduced baby deaths and improved care in the region.

Royal College of Midwives deputy general secretary Louise Silverton said: “If midwives do not have sufficient time to assess and support women things including identification of risk factors can get missed.”

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Readers' comments (1)

  • 'The report recommended more community midwives to reduce caseloads, more training around social need, improved hand-held maternity records, and community-based ultrasound services.'

    It does not take a genius to know that if staff do not have time to make the correct checks it is going to be spell disaster.

    What has not been mentioned is that midwives also work on call rotations, at last once a week. This means they work all day including the extra hours each day requires from them, they may be up all night, and then, yes, and then, they are expected to work the following day. What self respecting man would like his wife to be looked after by a midwife who had been up all the previous day, most of the night and then was planning your dear beloved's care in her wonderful and precious pregnancy.

    Strange that there is no mention of this in the report! How many people work these sorts of hours. If the midwife by chance is not called out, she will have her sleep disturbed by clients calling her for advice. I believe, they get paid £10 for being on call and if they are called out they will then be paid for the hours they are out.

    Not at all like the way doctors work! I believe our Health minister is married to a GP! GP's changed their working practices. They have 'out of hours services', they no longer have to go out at night. The doctors that work in these services are provided with drivers too!

    Midwives go out, often alone initially, driving themselves there and back. They have lone worker policies that keep them safe of course! Has anyone reading this got a desire to drive alone, at four am to Birmingham centre and look for an address, empty equipment out of a car, be alone in a strange home?? They have to risk assess their own safety and ability to work, if they are too tired they should state that fact to their employer and not go, but how many will do that, because they know if they don't go then a colleague will.

    I am married to a midwife, it annoys me to see how stressed she is, the risks she takes with her own safety, how this is taken for granted, how much she is expected to do.

    She is almost paying the NHS to use her own car for her work, the mileage no longer reflects the cost of her petrol and car depreciation. I have encouraged her to leave, finally she is seeing sense, noticing how her own health is being affected. As the report states, she is not the only one. Midwives can no longer work like this and it is about time the NHS looked at the on call rota's, the petrol costs and work loads.

    I am afraid this report does not even touch on the reasons for why women lose babies, have their health and their babies health undermined by the NHS. The fault lies firmly at the door the the Prime Minister who continues to ignore the professionals at grass roots.

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