‘There is no doubt that maternity care, like the rest of the NHS, is looking into a storm of possible cuts to services,’ said Cathy Warwick, General Secretary of the Royal College of Midwives (RCM) yesterday.
She added: ‘I am here to warn of the folly of such a course.’
Warwick was responding to a King’s Fund think tank report that suggested maternity units should offer midwife-led care as the norm rather than the exception.
The report said that last year only ten per cent of hospital births in England were in midwife-led wards.
It warned financial pressures mean it is unrealistic to expect significant increases in midwife numbers.
The RCM said an extra 4,000 midwives were needed before a change in care patterns could be implemented.
While welcoming the report, Warwick continued: ‘The birthrate is showing no sign of changing from the historically high rates we are seeing.
‘Births are becoming increasingly complex adding to the demands on midwives’ time, and midwife numbers have simply not kept pace to cope adequately.’
The RCM agreed that midwives can take on new roles such as examination of newborn babies.
However, these new roles should not be added at the expense of the essential care many midwives are currently struggling to provide because there simply are not enough of them to deal with their current workload.
The RCM also has concerns about suggestions for other health workers taking on roles in maternity care.
The RCM is adamant that you cannot compensate for not having the right number of midwives by transferring care that only midwives can and should provide, to other members of staff.
The RCM further warned: ‘The report’s focus on labour and birth may also deflect from the pressing need for good quality antenatal and postnatal care.
‘Two recent reports from CMACE and the West Midlands Perinatal Institute specifically addressed the importance of good care in these periods.
The CMACE report also highlighted that the leading cause of maternal death was infection, often developing after the birth.
‘This positively puts out the message that regular postnatal visits from midwives are essential.
‘The RCM has heard about postnatal visits being cut to as little as two visits because of staffing issues.
‘Here is one concrete and specific example of how having the right number of midwives to ensure the right number of postnatal visits will improve safety.’
Warwick added: ‘It is difficult, if not impossible, to re-organise your workforce if you do not have enough of them in the first place.
‘Midwives, support workers and other personnel are all needed to provide a safe and high quality service that offers women the choices they have been promised, and to give them safe and high quality care.
‘As this report says, you need the right numbers of staff, in the right place at the right time. Anything less fails women, will lead to inadequate care and may possibly even endanger their safety.’
