Crisis as midwives shortage worsens

THOUSANDS OF women are being left without professional support during child birth because of a chronic shortage of midwives, according to an official report.

The report by the English National Board for Nursing, Midwifery and Health Visiting found that a quarter of maternity units across the country had a severe shortage of staff, a third were unable to provide one-to-one care and many women were left unsupervised in the final stages of labour.

"There are very few midwife units in the country that have a full quota of midwives," said Tony Smith, chief executive for the board.

The report, which looked at 124 units in the country, found that 22 per cent of units had severe staff shortages.

"There has been a rise in Caesareans and it is possible that, among many factors, this is due to midwives being unable to be with a mother throughout the birth," Mr Smith said.

In the past two years, the number of Caesareans performed in England has risen by 1.5 per cent and now accounts for 17 per cent of all births.

Morale among midwives was found to be poor, with staff working under severe pressure. Senior midwives said the shortage was putting maternity services across England under severe strain and called on the Government to review midwifery and improve working hours and pay.

Official figures show that since 1988 the number of midwives working full time has dropped from 20,567 to 17,396, in 1999.

Louise Silverton, deputy general secretary of the Royal College of Midwives, said that the Labour Party had done nothing for midwives since it took office.

"The contribution of midwives to the health of the nation is not valued by the Government," she said. "It takes a lot of money and time to train midwives. They are very skilled practitioners and should be treated as such."

The college is campaigning for midwives to be given a basic salary of pounds 17,000 and more flexible working hours.

Tessa Jowell, the Public Health minister, said the report was "very disturbing" but insisted a pounds 5m campaign to encourage professionals to return to the NHS had put 1,200 nurses and midwives back on the wards.

Professor Lesley Page, of Queen Charlotte's Maternity Hospital in London, said there was a need to improve recruitment and to allow midwives to follow their patients' progress throughout their pregnancies to reduce the number of Caesareans performed. "This situation is partly due to the shortage of midwives and it is partly due to the fact that midwives are organised inappropriately," Professor Page said.

"We have known for some time that Caesarean rates are now quite astronomical and I think it is a problem of things not being done properly in labour. If a woman is left alone in labour, then she is much more likely to need an epidural [a pain-killing injection], which in itself leads to an increase in the need for Caesareans."

Jon Skewes, the head of industrial relations for the Royal College of Midwives, said the shortage of midwives was unlikely to change. "Far from being arrested, the drop is continuing. Many midwives tend to be in their forties and fifties which, combined with the fact that fewer people are now joining midwifery, gives us cause for real concern."