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Maternity services on knife-edge, warn midwives

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Midwifery leaders have warned that maternity services are “on a knife-edge” just as the biggest baby boom in 40 years is expected.

The Royal College of Midwives says there will be more than 700,000 births in England this year - and there were 4,600 more babies born from January to March than last year.

But with maternity services being reduced across the NHS nationally, RCM chief executive Cathy Warwick warned: “Today’s midwives simply have never seen anything like it. The demand this is placing on the NHS is enormous.

“The baby boom is restarting with renewed vigour. We are already at birth numbers that haven’t been seen for at least a couple of generations, probably not in the working life of any midwife practising today.”

The warning comes as the government announced £25m funding for en-suite overnight rooms in maternity wards and other facilities for expectant mothers.

The RCM said over a quarter of midwifery department chiefs say they have endured budget cuts in the last 12 months while the average number of births per midwife has increased, and it reckons there is a shortage of 5,150 full-time equivalent midwives.

Student midwife numbers are being cut, those who are just qualified are finding it hard to secure work - and a third of them are unemployed.

Just under 90% of 2,000 midwives questioned for a poll said they are unable to give women the care they need.

Ms Warwick added: “NHS maternity services, especially in England, are on a knife-edge.

“We have carried shortages for years, but with the number of births going up and up and up. I really believe we are at the limit of what maternity services can safely deliver.”


  • 1 Comment

Readers' comments (1)

  • Latterlife Midwife

    I wholeheartedly agree with what Cathy Warwick of the Royal College of Midwives is saying.

    When will the government start taking this crisis seriously? When will the public realise that giving good and adequate care is primarily dependent upon having enough midwives to go around? That requires more money, and better management of that money.

    If they want excellent care, they not only must demand a safe ratio of women-to-midwife in community midwifery settings, and for in-hospital antenatal and postnatal care; they must also be getting one-to-one care in active labour! This has been proven to be the only safe way to care for mother and fetus at such a stressful and often high-risk time, so that proper monitoring and assessment of the health of both, as well as providing comfort, coping skills, and anticipatory midwifery skills, may occur. That is how government takes care of approximately half its residents, and indicates how they feel about their newest ones, our babies.

    Having enough really good midwives helps to head off antenatal problems by helping with optimal weight gain, improved exercise, reduction/stopping of smoking, teaching what to expect and what is abnormal, imparting knowledge of risky behaviours and of prompt reporting such as reduced fetal movements or symptoms of preterm labour, preparing for labour and birth options, and of course, the mums who had assumed they would bottle-feed learning about breastfeeding, and finding it IS for them and their baby, after all, etc, etc.

    Having enough really good midwives helps to head off intrapartum (labour and birth) problems such as prolonged labour, excess interventions, birth injuries, and haemorrhaging for mum, and helps women start breastfeeding successfully right from the delivery bed. It helps avoid feeding, blood glucose, and temperature problems for the newborn, and gives an opportunity to show and teach the parents about newborn behaviour in the first few hours, helps mum to bathe/shower and eliminate, during which assessment is going on, and the discussion of birth events and their feelings.

    Having enough really good midwives helps to head off postnatal issues such as infections, depression, lack of bonding, and breastfeeding problems for mum by observing and assessing, and carefully reviewing discharge information and instructions, so they know what to expect and how to recognise situations out of the norm. It helps ensure the health of newborns because the last person to see that infant before going home is the midwife who will then have the chance to catch a problem, or by knowing when baby nursing/bottle-feeding well or not, knowing that the parents have learned about jaundice and what to do if they see it, about normal elimination, and keeping a baby close and preferably skin-to-skin at times, and not excessively warm - all of which heads off feeding problems/failure-to-thrive, dehydration, severe jaundice in the newborn, and infections.

    How a mother and baby, or parents and baby, start out can influence their health and welfare for many years to come. Though many disciplines and variables are involved, the midwife is the front-line practitioner. Already, ‘preparation for childbirth’ classes have been reduced. Postnatal midwifery visits at home have been reduced, or even eliminated in some parts of the UK. And in most regions, one-to-one care in labour is only a dream. Imagine being the mum in the throes of labour who needs attention from her midwife, who is caring for a few others in active labour, so you need to wait, and wait, and wait... That is morally wrong, and potentially very dangerous, as we've seen time and again.

    Stop taking money away from nursing and midwifery, and face the fact that there are too few practitioners and too much to do for it to be done well enough for our patients. We are burning out and our patients are suffering. Provide us with what we need to do our jobs with excellence; know that it is so very worth it in the long run; and admit that the future is going to be very grim if you choose not to.

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