Letter: Obstetrics in crisis
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Sir: The Royal College of Midwives welcomes the letter from Ishbel Kargar (11 May) which points out the looming shortage of midwives in the National Health Service. Experienced midwives are able to provide care, under their own responsibility, for approximately 80 per cent of pregnant women throughout the whole of their childbearing experience.
There is a need for junior obstetricians to receive teaching and supervision from senior colleagues. To this end the RCM is supporting the Royal College of Obstetricians and Gynaecologists in saying that there needs to be a consultant obstetrician available to oversee the care in labour of women with complications for at least 40 hours during the week. However, the we remain to be convinced that there is a place for the consultant obstetrician in the care of women experiencing normal pregnancy and labour. If obstetricians devote their energies to women who need them most, there may well be sufficient consultants.
As Ishbel Kargar also points out, the problems arise from poor working conditions of midwives and lack of implementation by trusts of government policy on pay and salary structures for midwives.
LOUISE SILVERTON
Deputy General Secretary
Royal College of Midwives
London W1
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