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Midwifery Shortages in the NHS : is safety being compromised?


    There has been a lot of press coverage in the media recently about midwife shortages in the NHS. But what are the reasons behind it and are we and our unborn babies being put at unnecessary risk?

    By Rebecca Callard

Why is there a shortage of midwives?

According to the Royal College of Midwives, the number of babies being born in Britain is on the rise year on year.  The South west alone saw the biggest increase in births compared to any other region in England in recent years.  However, according to the Royal College of Midwives the total number of midwife placements in the same period rose by only 9%, and cuts to the number of midwifery places in the NHS Trust were made by 3%.

There may of course be other reasons, aside from the increase in the number of births, as to why there are now midwife shortages, such as changes to doctors working hours.  Recent changes have meant doctors’ working weeks are now 7 days long, removing overtime payment prospects and stretching departments with more need for weekend shifts as junior doctors are now more reluctant to qualify into those departments with the new contracted hours.   This is likely to be adding to the problem as midwives become further over-stretched.

The Royal College of Midwives have also stated that there has been a rise in the number of complex pregnancies and births (including multiple births, obesity and mothers of an older age) which has impacted upon midwifery numbers due to the budget cuts.  Surely however this would indicate even more of a need for cuts in this area of medicine to be minimised?

Is there a risk to the safety of mothers and babies?

It is reported that the shortage of midwives in now in excess of 2,500 midwives.  The impact of this is that many units are having to physically close their doors to patients because they do not have enough staff to deal with them and so patients have to go elsewhere.

Rather shockingly to me, the Royal College of Midwives reported recently that one in four mothers did not have a midwife present during their labour.  At what must be, particularly for first time mothers, a scary and daunting experience, surely having a midwife present during labour is a basic treatment right on the NHS?

The Royal College of Midwives has admitted that these cuts are already having a major impact on births and that mistakes are likely to be made as a result.  The impact of these cuts will not only put unborn babies at risk, but mothers as well.

The impact of the shortages

Low morale of staff of dwindling departments must be adding to a stressful situation and the prospect of further cuts can not be raising that morale.  It is a vicious cycle as low morale and stressful working conditions will likely only lead to further midwives leaving their roles.

Where serious injuries occur to babies through a lack of trained medical staff and support, those children can suffer serious brain injuries which affect their entire life, needing specialist care and equipment.  Negligence cases against the NHS for babies who suffer such injuries frequently cost the NHS millions of pounds.  The government is very keen to reduce the amount of money being spent on negligence claims and therefore it seems to me that investing in obstetric and midwifery care, rather than cutting services, has to be crucial to reducing these costs, notwithstanding the obvious need to try and avoid babies suffering these injuries in any event.

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