Cathy Warwick: Hospitals are falling over the edge

More women are having babies and we haven't got the staff to deal with those who are older, obese, or who have conditions which, in the past, would have precluded child bearing. Many trusts do not have enough space and some units are overwhelmed, especially in London.

We have been holding things together for some time, but now some units are falling over the edge. When there is a failure of leadership the whole thing collapses. If you talk to midwives I believe they would say morale is low: too many women and too few staff. We accept there is a need to change the way we work. But we are 4,500 midwives short. Where maternity services go wrong is in the monitoring of mothers and calling for help when things are going wrong.

That comes back to pressure on services – not spotting the women who are at risk – because they are over-stretched.

The writer is General Secretary, Royal College of Midwives