Hewitt pledges greater choice for home births

Women will have a choice of where to give birth and whether they want a midwife or a consultant present. They will also be able to see a midwife rather than a doctor at the onset of pregnancy, if they choose.

But yesterday's pledge by the Health Secretary, Patricia Hewitt, provoked warnings that the shortage of midwives could make it impossible to deliver.

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More women would be giving birth at home, if that choice was available everywhere in the country, Ms Hewitt, claimed. Nationally, only two per cent of births take place at home, and research by the Royal College of Midwives suggests that only one mother in five is given that opportunity. But in some areas like south London and Torbay the proportion of home births is five or six times higher.

Ms Hewitt also promised that every birth will be supervised by a professionally qualified midwife, rather than by the less-qualified maternity support workers. But she admitted that no new money was being earmarked for maternity services, which currently gets £1.7bn a year, although overall the NHS budget was rising by over seven per cent this year.

There are 1,000 new midwives being trained, who will qualify in the next couple of years. There are about 19,000 midwives now in post. The Royal College of Midwives has said that another 3,000 are needed.

Ms Hewitt said: "This will mean that care is designed around the needs of women and their partners.

"Each primary care trust needs to look at what its workforce requirements are, then through the strategic health authorities we can work with those areas where they will have the biggest challenge in getting their staffing numbers up. We are signalling that maternity services will need to be a higher priority for the NHS in future years."

Yesterday, Ms Hewitt visited the Queen Charlotte's and Chelsea Hospital in west London to meet staff and new mothers. Asked why the Government was promoting home births despite its increased risks, she said: "I think the important thing here is to give women choice and give them the information so they can make an informed choice."

Professor Allan Templeton, president of the Royal College of Obstetricians and Gynaecologists, welcomed the emphasis on choice, but warned safety must come first. "If we are to provide mothers with more choice, then this can only happen when our places of birth are fully staffed."

Dame Karlene Davis, from the Royal College of Midwives, supported the plan but warned: "We are obviously concerned that there will need to be enough midwives to make it happen. There are variations across England in terms of the type and quality of service that women receive and we certainly want to see that the Government puts in place levers to ensure that this happens for every woman in England and not just the most vocal or articulate women who can receive it."

The shadow Health Secretary Andrew Lansley said 400 trainee midwives would not find employment in the NHS this year. He added: "I find it astonishing that Patricia Hewitt can mislead expectant mothers and unemployed midwives by making this announcement without acknowledging the shortage of midwives, that ante-natal classes are being cut or that Labour are divided over threatened maternity unit closures."

Amstey Gilley, 31, and Kal: 'Pregnancy is not a medical condition'

After giving birth in a hospital, Amstey Gilley, 31, from Liverpool, had her second delivery as a home birth on the NHS. After giving birth to Kai (now three-and-half years old) through an emergency Caesarean section she wanted to have her second child, Tawny (born February 2006), at home.

Ms Gilley says: "I discovered that it's safer for women who have had a Caesarean to stay at home the second time round because you are so much more likely to end up having another Caesarean once you start the process of intervention. When I first mentioned home birth to my consultant she said, 'no we don't do that'. One midwife was very negative. She said, 'How would you feel if the baby died'. It was very scary but I expected that response.

"I felt relaxed at home in a normal environment and not in a sterile and medicalised hospital. Pregnancy is not a medical condition. It should be about life."

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