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UK Health minister, John Denham
"We're going to train 50 per cent more midwives"
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Jackie Best
"My Caesarean was a horrible experience from first to last"
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Tuesday, 7 November, 2000, 09:18 GMT
Birth problems blamed on staff shortages
Caesarean sections are becoming more frequent
A lack of fully trained staff in labour wards is contributing to the number of babies born brain damaged, a leading doctor has said.

The warning from Professor Robert Shaw, President of the Royal College of Obstetricians, comes as midwives and doctors express concerns about the numbers of women having Caesarean sections instead of natural births.

This trend has been blamed on a shortage of trained midwives.

Professor Shaw has warned the government's target of cutting the level of claims for medical negligence involving childbirth by a quarter will be impossible to achieve unless more resources are made available to recruit highly trained staff.

Professor Robert Shaw
Professor Robert Shaw said more staff were needed
Currently 2,000 claims for medical negligence related to obstetric care are being considered.

He told the BBC: "Clearly, if there were larger numbers of fully trained obstetric and midwifery staff available to intervene immediately problems arose this could help reduce the frequency or the severity of problems when they occur.

"In many instances when we analyse these cases we find there are delays in seeking further help from senior people, or there are problems in interpreting the heart rate traces, or signs that problems are arising at an appropriate time."

Caesarean figures

The latest figures show that in 1999, 41% of NHS maternity units in England completed more than 20% of deliveries by Caesarean.

The figure for maternity units carrying out this proportion of Caesareans the previous year was 27%.

The latest figures also show that one unit completed more than 30% of deliveries by Caesarean, a level well in excess of World Health Organisation recommendations.

A conference of the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, and the National Childbirth Trust will discuss the problem on Tuesday.

According to the English National Board for Midwives, almost a third of units are unable to provide women with one-to-one care during labour, and studies have shown that a lack of continuous midwifery support increases the chances of Caesarean section.


Karlene Davis, General Secretary of the Royal College of Midwives, said: "It is appalling that women are left alone at a time when they need the attentive care and support of a midwife.

Health Minister John Denham
John Denham promised more consultants and midwives
"For a number of years the college has warned of the consequences of midwife shortages. Urgent action is now needed to tackle this problem."

Flexible systems have been introduced by some hospitals to try to reduce the number of women having Caesarean sections.

Belinda Phipps, Chief Executive Officer of the National Childbirth Trust, said: "One-to-one support throughout labour is not only beneficial for women but also cost-effective because clinical outcomes are better.

"We now have evidence that women without complications can avoid interventions in childbirth if they go to a midwife unit or birth centre rather than a hospital."

Health Minister John Denham said the government recognised the need for more midwives and consultants.

He said the number of training places for midwives would be increased by over 50%, and efforts were being made to encourage experienced staff who had left the NHS back into the profession.

"We have also got to make sure we have uniformly high standards, to make sure that staff are properly trained in foetal monitoring, for example."

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See also:

14 Jan 00 | Health
Caesarean choice 'can be a risk'
02 May 00 | Health
Crackdown on Caesarean boom
09 Aug 00 | Health
Big rise in Caesarean births
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