Midwife crisis will 'let down' a whole generation of new mothers Figures show shortage will persist until 2026 despite David Cameron's pledge to make childbirth an NHS priority.
The NHS's chronic shortage of midwives will last into the mid-2020s, despite ministerial pledges to improve maternity care amid a continuing baby boom, according to new figures.
The calculations, by the Royal College of Midwives (RCM), suggest that the gap between the number of midwives the NHS in England needs and the number it now has will not be closed until 2026. The shortage is certain to force maternity units to close suddenly and lead to some mothers receiving inadequate care before, during or after giving birth.
Belinda Phipps, chief executive of the parenting charity the National Childbirth Trust, said women giving birth between now and 2026 would be let down as a result of the shortfall. "It's extremely frustrating to think that we'll have to wait 13 years before mothers are getting the level of support they need. Childbirth is so important that they shouldn't have to wait that long. A whole generation of mothers and babies will not get the support they need."
She criticised ministers for not taking maternity care more seriously. "Given the government's understanding of the importance of the first 1,000 days of parenthood, which starts at conception, it's disgraceful that they aren't acting more quickly to ensure that women get proper support in those first 1,000 days from midwives. The rhetoric is there about that period, but it looks like they're not backing it up with action," Phipps added.
The Care Quality Commission (CQC), the NHS care regulator, last year warned that one in seven of the 141 hospital trusts in England that provide maternity services did not have enough midwives. Maternity care was "emerging as a problem area for a number of NHS trusts, due to midwife numbers not increasing in line with demand and an increase in complex births, owing to risk factors such as maternal age, weight and co-morbidity", it said.
The acute shortage is leading to the temporary closure of both some hospital maternity units, forcing mothers-to-be to go elsewhere when they are already in labour, and some midwife-led birth centres. The Trowbridge Birth Centre in Wiltshire shut on 15 July for 12 weeks until 29 September because of staffing problems there and at maternity units nearby. Women now have to travel 13 miles to Chippenham's birth centre.
Trowbridge's midwives are now working both there and in the Princess Anne wing of Bath's Royal United hospital to help fill gaps in the rotas. Earlier this year the CQC voiced concern that the Princess Anne wing had "not enough qualified, skilled and experienced staff to safely meet people's needs at all times". Great Western NHS Foundation Trust, which runs all those units, is recruiting more midwives to tackle the problems.
The projections are uncomfortable for David Cameron who, before the 2010 general election, voiced concern about staffing problems in NHS maternity units and pledged to recruit 3,000 more midwives. However, official NHS figures showed that the number of qualified midwives in the NHS in England had only increased from 20,132 in May 2010 to 21,410 in April this year – a rise of just 1,278 in three years under the coalition.
Cathy Warwick, the RCM's chief executive, welcomed the increase in midwives but said the NHS is still 4,501 below complement, based on the ideal ratio of one midwife for every 28 births in a year – a figure the Department of Health accepts. While there are likely to be 697,893 births in England this year, there are 21,356 full-time equivalent midwives, which means each one handles 32.2 births. It needs those other 4,501 midwives to guarantee both safety and quality of care, Warwick added.
The RCM's projections show that, if the rising birthrate seen between 2010 and 2012 continues at the same rate, and the number of midwives in the NHS keeps growing at the rate seen recently, the shortage of midwives will fall from 4,501 to 2,276 in 2020, then 811 in 2024, before finally disappearing in 2026, although the ratio of 28:1 will be achieved slightly earlier, in 2024, the analysis shows.
The Department of Health says it has taken action to ensure 5,000 midwives are being trained. But the RCM says numbers in post are not rising accordingly because hospital trusts are not hiring as many as are needed. In April, deputy prime minister Nick Clegg, confronted by a student midwife on his radio phone-in, denied that ministers were "deceiving" voters by emphasising the 5,000 training places, but admitted that some trusts were too cash-strapped to boost their midwife numbers.
Labour claimed the RCM's figures showed the prime minister had broken his "cynical" pre-election pledge and that mothers were being failed. "On David Cameron's watch we're seeing maternity units downgraded or facing closure as hospitals struggle with NHS budget cuts. The lack of midwives has left some units with no alternative but to temporarily shut their doors," said Diane Abbott, shadow health minister.
"New mums are being badly let down. David Cameron needs to get an urgent grip on the staffing shortages across the NHS. One in 10 hospitals is understaffed as almost 5,000 nursing jobs have been lost since the election. The time for excuses is over. Patients cannot afford for the government to ignore expert warnings," Abbott added.
Dr Dan Poulter, the maternity services minister, said the figures were "based on simple assumptions" and don't take account of the 5,000 trainee midwives who will qualify in the next three years.
"It is because of the historical shortage in the number of midwives that from day one investing in maternity care has been a top priority for the government. There are nearly 1,300 more NHS midwives now than there were in 2010, including over 400 more in the last year alone," he said. The Guardian
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