Letter: Midwives cut

Sir: One-to-One Midwifery Care, an innovative scheme for mothers and babies in west London, which reaches many deprived groups and is loved by those who use it, is to be cut if health commissioners have their way. Why? Not because it is expensive but because it is seen as a soft target for further health cuts.

The scheme means that most women have care in labour from a midwife they know well, and also have "continuity of carer" during pregnancy and after the birth. One-to-One midwives carry a personal caseload of women with backup from their partner and, when necessary, others in the group practice. This is different from "team midwifery" where several midwives all have equal responsibility for a much larger number of women and there is less chance to build a relationship of confidence and trust. The health authority concerned is now planning to introduce a team scheme.

The underlying problem is that unrealistic ratios of midwives to births are set as a short-term, cash-saving measure. It is scandalous that expensive - and often useless or even dangerous - technology is used more and more each year regardless of the growing cost or evidence of effectiveness. Yet asking for support from a familiar midwife on that special day in your life when you give birth is apparently too much to ask.

MARY NEWBURN

National Childbirth Trust

CHRISTINE GOWDRIDGE

Maternity Alliance

BEVERLY BEECH

Association for Improvements in the Maternity Services

London W3

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