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Chronic midwife shortage and red flag events reveal ‘crisis in maternity care’

A chronic shortage of midwives has meant that new mothers are receiving insufficient care on labour wards, a new report has found.

The report, published by parents’ charity NCT and the National Federation of Women’s Institutes (NFWI), warned that half of women encounter at least one “red flag” event during childbirth, such as waiting over half an hour for pain relief or over an hour to be given stitches.

The bodies said that the report revealed a “crisis in maternity care” and urged the government to make a greater effort to keep midwives in the profession.

“The findings from this report show that chronic midwife shortages (an estimated 3,500 in England alone) continue to undermine the delivery of high-quality care for women and their families,” said Marylyn Haines Evans, public affairs chair for NFWI.

“Women have told us that midwives are working hard to do the very best that they can, but that there are simply not enough of them to go around.”

The report’s online survey of almost 2,500 women revealed that most women (88%) did not know their midwife before they went into labour or gave birth, suggesting that continuity of care remains an issue.

Of these women, 12% said that it made them feel alone and vulnerable as others reported feeling like “cattle” or a “product on a conveyor belt”.

“No women should have to suffer a red flag event when bringing a baby into the world,” said Elizabeth Duff, senior policy advisor for NCT. “Severe staffing shortages must be acted on so that every family receives an acceptable level of care.”

Other concerns raised by the report included women not understanding all the risks associated with their pregnancy and not feeling able to discuss these openly, and women not seeing a midwife as often as they needed postnatally, risking delayed diagnosis of health problems.

Louise Silverton, director for midwifery at the Royal College of Midwives, said the report highlighted the pressure that midwives and maternity services were under, saying there are too few resources and not enough staff.

She highlighted the lack of consideration that maternity services currently face in NHS sustainability and transformation plans (STPs), with RCM analysis recently finding that over half of all new STPs make no or passing mention of maternity services.

“Serious and sustained investment in maternity care is needed to counter the huge increase in births over the last decade or more, the increasing demands on the service and the historical lack of funding,” said Silverton.

The NCT and NFWI’s report set out a series of recommendations for maternity planners and for the Maternity Transformation Programme Board in order to improve women’s experiences of maternity.

Suggestions to service providers included implementing NICE guidance on safe staffing levels, improving postnatal care and ensuing continuity of care, as set out in the recent National Maternity Review.

(Image c. David Jones, PA)

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