Record numbers of births to older mothers are putting maternity units under intense pressure, as midwifery faces a “retirement time bomb”, a new report has warned.
The quality of services women receive is suffering because of midwife shortages, this year’s State of Maternity Services Report from the Royal College of Midwives has concluded.
“We’ve found a midwifery retirement time bomb – and it’s ticking”
The report repeated the college’s estimate that 2,600 more midwives are needed to address staffing shortfalls in England.
“It is deeply frustrating for midwives that they cannot provide the quality of maternity care they want to deliver because they are so short-staffed,” said RCM chief executive Cathy Warwick.
“It would be far better if they could spend more time helping pregnant women to quit smoking and helping new mums to breastfeed,” she said.
“Too few midwives also means less time with women, with rushed midwives potentially missing signs of depression,” she added.
The report highlights increases in the number of babies born to women in their 30s and 40s – more likely to be higher risk births that need additional care.
In 2014 the number of babies born in England and Wales to women in this age bracket went up by 6,859.
Birth figures from the same report last year suggested the baby boom of recent years might be on the wane, with a significant drop in the number of births.
However, this time round the overall fall in the number of babies born in the UK as a whole in 2014 was just 0.3% down on the previous year. Numbers of births in Scotland and Northern Ireland went up.
“We just don’t know if numbers will start rising again this year,” said this year’s report from the RCM.
“We need to ensure that enough midwives are brought in before we lose an increasing number of midwives to retirement”
Meanwhile, the average age of midwives themselves is also increasing, with many preparing to leave the profession.
Last year is believed to be the first on record when the NHS employed more than 1,000 midwives in their 60s, while the number aged 65 or over rose from just eight in 2001 to 177 last year.
The report found around a third of midwives in England – 31% – are now aged 50 or over and figures for Scotland and Northern Ireland also show an ageing workforce.
In Scotland, 42% of midwifery staff – encompassing midwives and maternity care assistants – are aged 50 or older, and in Northern Ireland 41% of midwives are aged 50 or over.
The RCM does not have age profiles for midwives in Wales, but it suggested the pattern was likely to be the same.
“We’ve found a midwifery retirement time bomb – and it’s ticking,” stated the report. “Thankfully we still have time to defuse it, but we need to start before it’s too late.”
At the very least, the report said there must not be any cuts to midwifery training numbers in any of the four UK nations and, ideally, training places should be increased.
“The administrations should maintain the financial support given to student midwives too, to ensure as many as possible stick with their studies and are not forced to quit through strained personal circumstances,” the report added.
Professor Warwick said older midwives had a key role to play, but said it was also vital to bring in and nurture new midwives.
“Many older midwives will, of course, be very experienced and they are able to mentor and support newer, younger midwives,” she said.
“But they won’t be around in the maternity units forever,” she said. “We need to ensure that enough midwives are brought in before we lose an increasing number of midwives to retirement.
“If we put off dealing with it for another year, it will be far too late,” she added.
Health secretary Jeremy Hunt acknowledged the need for more midwives when he answered questions in parliament earlier this month.
“We need more midwives,” he told MPs. “We recruited more midwives in the previous parliament and we do need to expand maternity provision as we have a growing birth rate.”
He added that findings from the national review of maternity services, led by Baroness Cumberledge and expected early next year, “will help us to address this problem sustainably”.