Friday, July 30, 1999 Published at 19:36 GMT 20:36 UK
Government accused over midwife shortage
Midwives are in a "vicious cycle" of staff shortages and low morale
The government has been accused of failing mothers-to-be after a leaked report showed that thousands of pregnant women were missing out on midwife care in labour.
And Conservatives said the government had made maternity care a "low priority".
The criticism comes as the BBC revealed that an as-yet-unpublished report by the nursing and midwifery regulatory body, the English National Board, found maternity units across the country were failing to provide the recommended levels of care.
The government said it was trying to tackle the shortage, but figures released by the Royal College of Midwives (RCM) show the problem is getting worse.
The number of registered midwives in the UK has dropped by more than 2,500 in the last four years to 32,803.
And the problem could get worse since many midwives are middle-aged and will soon be eligible for retirement.
The ENB report said almost a third of maternity units are unable to provide one-to-one care for women in labour, and many women are left unsupervised during the final stages of labour.
The proportion of deliveries undertaken by midwives has fallen - in some places nearly 50% of deliveries are being performed by doctors.
And the report said that morale among midwives is poor, with staff working under "severe, sometimes extreme" pressure.
Several schemes aimed at promoting midwifery have been abandoned or modified.
The RCM says 60% of hospital managers cannot run an adequate midwifery service due to staff shortages.
Midwives being marginalised
The ENB suggests that NHS restructuring is to blame for the vicious circle of low morale, overwork and staff shortages.
Louise Silverton of the Royal College of Midwives said the health of women and their babies could be compromised by a lack of continuous care.
"The close monitoring that a woman requires during labour, and particularly towards the end of labour as the birth approaches may not be possible when a midwife is looking after more than one woman", she said.
Figures 'out of date'
However, the government said that while the findings were worrying, a recent recruitment drive was beginning to have an effect.
"These are very disturbing figures indeed," Public Health Minister Tessa Jowell told the BBC.
"And this year we have launched a £5m 'return to nursing' campaign aimed at getting those nurses and midwives who have left the NHS back into the NHS precisely to deal with these kind of problems," she said.
"We already as a result of the campaign have 1,200 nurses and midwives back on the ward, and another 2,500 are about to start the return to nursing training."
Claire Rayner, president of the Patients' Association and a trained midwife, backed the government's nursing recruitment drive.
But she said training took time and efforts needed to be concentrated on attracting midwives back into the profession.
"They don't want to meet a stranger in the delivery room," she said.