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Monday 18th June 2018

Labour of love?

5th April 2006

05042006_baby_ward.jpgA shortage of midwives means women are not receiving the care they want. The experience of labour can be made less stressful with reassurance and support during childbirth, or one-to-one care. Midwives also want to give this sort of care because it gives them more job satisfaction.

But the uproar over the Jentle Midwifery Scheme at Queen Charlotte’s and Chelsea Hospital, where women paid £4,000 for 'a different service', has exposed a major problem within midwifery — and fears that the kind of service women want will soon be limited only to those who can pay. Although one-to-one care is offered at some NHS hospitals and birth centres there is a shortage of midwives, making national provision apparently impossible.

Melanie Every, of the Royal College of Midwives (RCM), says that everyone recognises that one-to-one care is the best "but the funding has to be there".

The RCM estimates that 10,000 midwives are needed across the UK to deliver one-to-one care, and a recent RCM survey showed that almost three quarters of maternity units experience staff shortages. Retaining, as well as recruiting, staff is a problem, 69 per cent of midwives are aged 40 or over, and a quarter are over 50. This is a potential crisis in itself. There has also been a shift to part-time working which exacerbates the situation.

An NHS consultant in obstetrics and foetal medicine, Christoph Lees, recently coauthored a report on maternity services for the think-tank Reform. He says that there has not only been a significant reduction in the hours but there’s also been an increase in sub-speciality areas, so that fewer midwives are hands-on.

Midwives, he says, are taking on other roles such as training or psychiatric liaison which are important, but mean that "the inescapable conclusion is that there are almost certainly fewer bodies on the ground.?

Women increasingly want to balance the job with family life, which means that there are fewer midwives on call 24/7, and that night shifts are increasingly difficult to fill.

The Department of Health pointed out that investment in maternity services has risen since 2001 and that the number of midwifery students has gone up, from 1,652 in 1997 to 2,374 in 2004-05. However, persuading new midwives to stay in the NHS will be the real test.


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