Shortage of midwives is putting lives at risk

A chronic shortage of midwives is putting the lives of women and their unborn children at risk, the Government was told today.

Up to one in ten midwifery jobs in the NHS has been vacant for at least three months and more than three quarters of maternity units say they are experiencing problems recruiting more staff.

The Royal College of Midwives (RCM) said that at least 10,000 more recruits are needed to avert a crisis.

George Georgiou, employment relations officer at the RCM, said: "This is of major concern to us.

"The research has shown that women who are left alone during labour or do not have continuous care from a midwife are more likely to suffer complications and to need interventions such as forceps and caesarean deliveries."

In its election manifesto last year, Labour pledged that by 2009 all women would be given a choice over the kind of unit they had their baby in and alternatives over pain relief and stated: "We want every woman to be supported by the same midwife throughout her pregnancy."

But research by the RCM has found that midwife numbers have fallen by 6.2 per cent since 2000 and by 25 per cent over the last 12 years to around 33,000 full time equivalent posts.

The survey found that a quarter of midwifery units reported it was becoming harder to fill vacancies and only one in four midwives believed their unit was adequately funded.

Vacancy rates are worst in London and the south East, where one in ten jobs have been unfilled for at least three months.

Last month, the NHS Queen Charlotte's and Chelsea Hospital in the capital offered women the same midwife throughout pregnancy and labour - if they paid a £ 4,000 charge.

Dame Karlene Davis, general secretary of the RCM, said: "This compromises the RCM's belief that every women is entitled to high quality, one-to-one care with a midwife. This care should never be rationed by a woman's ability to pay."

A survey by the National Childbirth Trust has also found that almost a third of women had not had continuous care through their labour, with some saying they had been left alone, unsupervised, for long periods of time.

Britain has a low rate of maternal mortality, with around one in every 8,800 pregnancies resulting in the death of the mother.

However, there has been a slight rise in the rate recently and experts are concerned that women may already be dying as a result of midwife shortages.

A study in the British Journal of Obstetrics and Gynaecology found that more than half of perinatal deaths in England (deaths of babies immediately before and after birth) involved cases where sub-standard care could have been to blame - the highest rate in Europe.

A spokesman for the Department of Health said: "There are almost 2,500 more midwives working in the NHS than there were in 1997 and the number of students entering training has increased by 41%. There are shortages but these are being addressed in a number of ways including the provision of affordable housing and childcare."

Midwife's view: 'I can't do the job in the way I want to'

Sarah, 33, has worked as a midwife at a maternity unit in the south-east of England for four years.

She says that chronic staff shortages, low pay and poor conditions are contributing to the rising vacancy rate.

"I always wanted to be a midwife and I'm prepared to put up with not earning a huge amount of money," she said.

"But I hate that I can't do the job in the way that I want to because I am trying to look after six or seven women at a time. Even when I have done 10 years I will only be earning around £30,000 a year and I'm beginning to think it is not worth it.

"You can see that the women get really scared by the fact that they are not seeing the midwife who may have looked after them during their pregnancy.

"Sometimes you only have five minutes to look at their birth plan before you have to dash off. The worst thing is if you see someone who in their birth plan has been very motivated to have a natural birth and ends up having a Caesarean because the care has just been mucked up.

"People go into this job because they want to help women and children and in the end you feel it's just not worse the hassle."

Mother's view: 'I only wanted one midwife but had four'

When Catherine Gulati went into labour with her second child, she was determined to have a natural birth and hoped for continuous, one-to-one care with a midwife.

Instead she saw four midwives throughout her labour .

Mrs Gulati, 34, from Birmingham, said: "I became really stressed by the time the fourth midwife came."

When Mrs Gulati first arrived she was in the early stages of labour and sent to the antenatal ward.

"A midwife came to see me and she was very nice, but then she had to go and see someone else.

"When I went down to the delivery ward another midwife saw me but then she went off at the end of her shift so I was on to my third one.

"She was lovely and everything was progressing just how I wanted to.

"But then they were handing over again as my one had to go and see another woman.

"By this point I was really scared and in pain and I hadn't even managed to introduce myself to the new one yet.

"My whole labour just ground to a halt and I became a bit hysterical.

"I did have a natural birth and the midwife was really good, but it went on longer than it should have done. "