Midwife shortages across UK

By Dr. Ananya Mandal, MDSep 16 2011

According to a warning from the Royal College of Midwives parts of England are facing a dangerous shortage of midwives as Britain's birthrate climbs. The RCM added that while shortages are seen across the country, some areas are worse than others, putting mothers and babies at risk.

Midwife numbers have not kept pace with the birthrate in England, which has risen 22% in the past two decades, and the RCM has urged David Cameron to honour a pre-election pledge to recruit more midwives. The RCM report said 4,700 more midwives were needed across England to keep up with added pressures, including growing numbers of obese and older pregnant women.

Figures showed that the north-east and north-west had a shortfall of less than 10%, while the east Midlands and east of England needed 41% more midwives. The south-east was said to be more than one-third short of staff. While the north-east needed 91 extra midwives, the south-east required 1,015 more. A medium-sized maternity unit delivering 3,000 babies a year would need around 91 midwives, according to the RCM.

Cathy Warwick, the RCM general secretary, said, “This is not just a paper exercise to prove a point. These figures represent real and serious shortages in our maternity services. It is also not just about numbers. Births are also becoming increasingly complex, needing more of midwives' time. The combination of this and the rising birthrate is a dangerous cocktail threatening the safety and quality of maternity care. It means that too many maternity units across England are under-staffed and under-resourced to meet the demands made of them. It leaves me feeling deeply frustrated that we are not seeing any action from this government to remedy this.”

The calculations were made by measuring the number of midwives in an area against the number of babies. The disparity is a result of different levels of investment in different areas, the RCM said. Scotland, Wales and Northern Ireland do not have midwife shortages at the moment, it added.

The Department of Health said in response that the number of midwives has increased by 17.7% from 2000 to 2010. The country's birthrate has risen 19.9% in the same period, the Office for National Statistics said. There were 26,825 midwives working in the UK at the end of September last year, and 493 more midwives working in May 2011 than in May 2010.

A DoH spokeswoman said, “Record numbers [of midwives] entered training last year and there are 2,490 planned midwifery training places this year. Safety is paramount in the NHS, and all mothers and their babies should expect and receive consistently excellent maternity care. The Care Quality Commission last year found that 94% of women rated their care during labor and birth as good, very good or excellent.”

The shadow health secretary, John Healey, said, “This research shows how David Cameron's broken promise of 3,000 extra midwives is beginning to impact on patient care. But, as Labor revealed earlier this week, cuts to the funding of university midwifery courses are set to make things even more difficult, with a likely reduction in the number of midwives in years to come.”

Elizabeth Duff, the senior policy adviser at the parenting charity NCT, added, “Midwife shortages are already having an appalling impact on maternity services. Women in need of midwifery care cannot be left to languish on an ever-lengthening waiting list – they need care right away. Midwives are a unique resource, whose expertise in caring for women and their babies is not replicated by any other health professional. NCT joins in the call for sufficient midwives in post now, and more student places for those in training, so families can have confidence in improved maternity care for the future.”

The charity Action against Medical Accidents, AVMA, said the situation in some areas was desperate. “Having a baby should be the happiest time in a couple's life, but failure to deal with this problem is all too often turning it into a tragedy,” said AVMA chief executive Pater Walsh. “Maternity services should be the NHS's first priority for improving patient safety and having enough trained midwives is an absolute must.”