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'We’ve upped our monitoring of maternity care services'

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We are empowering midwives to report issues with maternity services in their area, says Cathy Warwick

Recent weeks have been potentially good for NHS maternity services in England, and for the growing number of women who rely on them each year.

The Department of Health pledged to give every pregnant woman one named midwife who will oversee her care during pregnancy and after she has had her baby. They also committed to giving every pregnant woman one-to-one care from a midwife during labour and birth. In addition, the government spelt out that mothers-to-be will get the best choice about where and how to have their baby.

This is music to my ears, especially after the coalition government had ditched the previous administration’s excellent Maternity Matters strategy upon assuming office. We now have some solid ways in which to assess whether incoming clinical commissioning groups are doing their jobs properly because we can easily measure whether these pledges are being honoured on the ground.

Indeed we have some baselines already. Working with the Bounty Word of Mum panel, we surveyed mums at the start of the year and found that a quarter did not always have a midwife when in labour when they felt they needed to have someone with them. That suggests we are a little way off meeting the one-to-one pledge.

“The government has now made clear commitments on improving maternity care. But those commitments must be honoured, and newly qualified midwives must be brought into the service as NHS midwives”

On choice of where to have their baby, just 43% reported being offered the option of a midwife-led unit and just over half (53%) said they were offered a home birth. So, there is plenty of room for improvement there too.
There was slightly more positive news about whether mums could contact midwives postnatally. Just 11% said they couldn’t, although this rose to a quarter in the capital.

We plan to create some mum-reported indicators linked to the new DH pledges to make sure they are happening from the perspective of the most important person in all this: the mother.

This is not the only way in which the Royal College of Midwives is going to monitor maternity care. By the time you read this we will have launched our Protect Maternity Services website.

You can access the site at and it is designed to empower midwives as well as other NHS professionals and members of the public to report issues with maternity services in their area.

We already know, for example, of birth centres in Kent and Scotland that will no longer carry out births. There is also the birth centre in Yorkshire that will close. We have also heard that an entire year’s worth of graduate midwives in Sussex have no jobs to go to, and that a trust in eastern England is cutting midwife numbers.
The government has now made clear commitments on improving maternity care. They have boasted about the number of students in training. This is all good, and we congratulate them on taking these steps. But those commitments must be honoured, and newly qualified midwives must be brought into the service as NHS midwives.

The previous government ended up having to earmark additional resources to maternity care when it became clear that improvements promised in Maternity Matters were struggling to see the light of day. Will this government be forced to do the same? We will have to wait and see. I hope it won’t be necessary because local commissioners will see the pledges that have been made and get on with delivering them.

We are moving into a brave new NHS world, and the RCM is meeting that challenge by upping its active monitoring of what is happening on the ground, and doing more of what midwives do best - listening to women.

Cathy Warwick is chief executive at the Royal College of Midwives

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Readers' comments (1)

  • It is disgraceful that newly qualified midwives are without a job when women are being left to labour on their own. And birth units being closed down when I have heard of units so busy they have to close their doors and women are turned away and have to travel miles to find another unit!

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