Letter: Crisis in obstetrics

Sir: The comments of Louise Silverton, representing the Royal College of Midwives (letter, 14 May), qualifying those of Ishbel Kargar (11 May), are welcome.

Kargar highlights the chronic underprovision of midwives, who rightly care for women in uncomplicated pregnancy and labour, but misses the point about the recommendation for more consultant obstetricians made jointly by the RCM and the Royal College of Obstetricians and Gynaecologists.

One-to-one midwifery care may well reduce the number of complicated labours, but women with problems in pregnancy and labour deserve to be looked after by an expert in that area. The need for more consultants has nothing to do with the number of women with such problems, but everything to do with the need to provide cover for all of them, whenever they need care. There will always be 24 hours in a day and 365 days in a year, however many midwives there are, and enough expert obstetricians are needed to cover these hours.


Senior Registrar in Obstetrics and Gynaecology

Wordsley Hospital, Stourbridge, West Midlands