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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.

Fergus Walsh reports: "The problems stem from an acute shortage of midwives"
The Liberal Democrats said the government had closed small hospital units led by midwives, not provided enough specialist doctors, and allowed a shortage of qualified midwives.

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The criticism comes as the BBC revealed that an as-yet-unpublished report by the nursing and midwifery regulatory body, the English National Board, found maternity units across the country were failing to provide the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 BBC's Niall Dickson: "Midwives are working under severe, sometimes extreme, pressure"
Virtually none of the maternity services is able to recruit the number of midwives it needs, with 15% of vacancies remaining unfilled.

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.

Health Minister Tessa Jowell: "There is a key and growing role for midwives"
As doctors become more involved and medical procedures such as Caesarians become more common, midwives have become marginalised.

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.

[ image:  ]
"But, first of all, the data on which this report is based is about a year old.

"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.

Professor Lesley Page: Same midwife should see woman throughout pregnancy
She believes having a midwife at labour is the ideal, but she thinks women are more concerned about having a familiar person caring for them throughout their pregnancy.

"They don't want to meet a stranger in the delivery room," she said.

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