Health correspondent, BBC South East Today
Shortages means fewer midwives are working harder to cope
A survey by BBC South East Today has revealed wide variations in the number of midwives working in the region and concern at the number of experienced staff leaving the profession.
The Royal College of Midwives said almost a third of those surveyed who were leaving the profession were doing so because they were dissatisfied with midwifery.
A total of 17% said they left because of family commitments and 11% because of a planned career.
But the RCN's report, published last year, concluded that: "Dissatisfaction with midwifery was, however, a major issue for all groups of leavers."
Although it is national problem the issue is particularly acute in the south east.
The numbers of midwives in trusts in the region are as follows:
East Kent Hospitals - 197 midwives and 10 vacancies.
Maidstone and Tunbridge Wells - 153 and 18 vacancies.
East Sussex Hospitals - 179 and 3 vacancies
Brighton University Hospitals - 100 and 4 vacancies.
Dartford and Gravesham - 62 and 8 vacancies
Medway - 121 and 10 vacancies.
With 5,000 births a year in Maidstone and Tunbridge Wells alone, there is a significant workload for midwives and while recruits are coming forward, there is concern they are not remaining in the profession.
Mary Tunbridge of Maidstone and Tunbridge Wells NHS Trust said a survey of midwives at the trust revealed an average age of over 40.
She said she too is concerned that younger staff seem less able to cope with the rigours of modern midwifery.
Low risk births
The shortages mean fewer midwives are having to work harder to cope with a steady birthrate.
Where 35 births is said to be a manageable caseload - the average in Kent is between 50 and 60.
There are two birthing centres in the region which are maternity units run by midwives.
In Dover and at the Crowborough Birthing Centre in East Sussex, they specialise in low risk births and are remote from other hospital sites.
At Crowborough, 326 babies were born from April 2002 until the end of March this year and half were water births.
There are also independent midwives such as Virginia Howes who decided to make the change from the NHS because she believed in the benefits of having continuity of care.
The Royal College of Midwives conclude members feel staffing levels are insufficient to enable midwives to practise midwifery effectively.
It calls on health trusts to re-examine the way midwives work and that only through changing practices will more midwives staff in the profession and others chose to join it.