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Wednesday, September 16, 1998 Published at 12:48 GMT 13:48 UK


Midwife crisis denies mothers' choice

St Michael's Hospital in Bristol has cut maternity services to ensure safety

A national shortage of midwives and cuts in maternity services are leading to many women being denied Caesarian births and painkilling drugs.

The BBC's Fergus Walsh reports on the midwife recruitment crisis
Midwives are warning that a recruitment crisis is denying women choice over how they have their babies.

Caroline Flint, former president of the Royal College of Midwives, said: "There is a huge national shortage of midwives.

"Midwives are very disillusioned at the moment."

She said women were being denied epidurals, Caesareans and home births.

"Women who are wanting home births are being told 'I'm sorry, you cannot have your baby at home, you have to come into hospital, we don't have enough staff to look after you'," she said.

The College blames the recruitment crisis on an erosion of pay and tough working conditions.


The situation is highlighted by news St Michael's Hospital in Britsol is giving new mothers just six hours to leave hospital after they give birth, although the time limit will be extended if there are complications.

The BBC's Matthew Hill: "Massive problems at St Michael's"
The hospital has also had to close a maternity ward and other services, including epidural and Caesarean sections.

The hospital is the leading centre of maternity expertise in the South West, but says it does not have enough staff to offer a full range of services safely.

Safety measures

Normally 80 midwives work at the hospital, but 19 have left and the hospital has been unable to replace them.

In a letter addressed to "mums-to-be", the hospital outlined the restrictions, which it said were designed to "maintain a safe service".

The letter said: "Newly delivered mothers will be encouraged to be discharged as soon as practicable following normal deliveries with normal outcomes.

"This means they could be discharged straight from the delivery suite within six hours of delivery, or shortly after transfer to the post-natal ward."

Reduced choice

Inductions and Caesarean sections will be available to women who must have them in preference to those who choose to have them.

Epidurals will not be available on demand because the hospital does not have the manpower to handle them.

The letter explained: "Because mothers who have an epidural require one-to-one midwife care, the numbers of available staff will probably only be able to accommodate an epidural based on clinical need.

[ image: Women's childbirth choices have been reduced]
Women's childbirth choices have been reduced
"An epidural request based solely on choice cannot be guaranteed."

Lynn Richardson, head of midwifery at St Michael's, said: "We are concentrating our staff in the key clinical areas to ensure a safe service."

National crisis

The United Bristol Healthcare Trust, which runs the hospital, blamed the cutbacks on a national recruitment and retention crisis in midwives.

Caroline Flint: "Huge shortage of midwives across the country"
Figures from the Royal College of Midwives show that there are 32,803 registered midwives in the UK - 2,500 fewer than in 1995.

The situation is made worse because the profession is getting older and more midwives choose to work part-time.

Melanie Every, a junior midwife administrator at the College, said: "We have something like 18% of the profession over 50 and only 8.5% are under 30."

Part-time working cut the number of midwives available and this increased the stress of working and led to more people asking to work part-time.

"The situation exacerbates itself," she said.

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