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Midwife-led maternity units under threat

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Standalone midwife-led centres are under threat from high costs and falling numbers of deliveries, analysis by Nursing Times sister title Health Service Journal show.

Seventeen out of 32 standalone centres – those not on the same site as a consultant-led unit – have seen falls in the number of women giving birth over the last three years, figures show.

The decline is variously attributed to GPs and mothers-to-be concerned about risk, poor marketing of the units and the fact many have had to close temporarily. In some cases the falls in births could affect the sustainability of the units.

The Royal College of Midwives has said midwife-led units with fewer than 300 births a year are unlikely to be financially viable if they are fully staffed around the clock.

Evidence also shows costs in midwife-led units can be significantly higher than consultant-led units. At East Kent University Hospitals Foundation Trust’s standalone midwife-led centre, births cost around twice as much as in the main hospital, said assistant head of midwifery Bine Browne.

But she added that benefits from midwife-led units included lower rates of intervention and higher breastfeeding rates.

RCM policy director Sean O’Sullivan urged trusts to support midwife units by looking at locating them within other NHS facilities to share costs. He said if the government was “serious about extending choice” then it should look at extending them.

Lancashire Teaching Hospitals Foundation Trust runs a centre in Chorley that has seen birth rates halve between 2008-09 and 2010-11. Rhona Hartley, head of midwifery and nursing for women’s and children’s services, said the trend could be linked to National Institute for Health and Clinical Excellence guidance that women with a body mass index of over 30 should have consultant-led care.

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