19 January 2017
UK Midwives Shortage: a View From a Midwife
Yet another report shows that reduced midwife numbers are affecting women’s care and experience during pregnancy, birth and the post-natal period.
The ‘Support Overdue’ survey jointly undertaken by the National Federation of Women’s Institutes (NFWI) and the National Childbirth Trust (NCT) makes sober reading. For more information on this, please see our previous blog: Midwife Shortage: a Red Flag Event
Having worked in the NHS and currently in private care, I know about the pressures midwives are facing as I have faced them. There are simply not enough midwives to cope with the workload. Some community midwives can have upwards of 15 visits a day with even 10 visits being a good day. – If you include travel time between the visits and paperwork that leaves very little time spent with the women in an eight-hour shift. The community midwives also run clinics, some with 15 pregnant women or more to see during 10 minute appointment slots.
If something drastic isn’t done to address midwifery numbers, then no amount of reports will help these women and babies that are facing ineffective and at times unsafe care.
When you have this level of work day after day the pressure mounts and safety is inevitably compromised. On a busy post-natal ward there can be one midwife caring for 10 or more women as well as their babies. That’s 20 patients each and it can be more or less than this depending on staffing levels. On the labour ward hopefully the midwife will only have one woman in active labour but she can also have women in early labour and women who have just given birth to care for. The woman in active labour will take priority here, which means that the other women and babies in that midwife’s care may be left alone for periods at a vulnerable time.
There are many reasons for the shortage of midwives in the UK, and why many leave the profession. A recent study by the RCM shed some light on this. For more information, please see: ‘Dangerous’ Working Conditions Forcing Midwives to Leave NHS
Dissatisfaction with how they carry out their duties is at the forefront of their reasons for leaving midwifery.
Newly-qualified midwives need experienced midwives to help them through their early career as do student midwives. Newly qualified midwives can often be left unsupported when staffing is short; this impacts not only on their well-being but on the safety of women and babies. Retention of these newly qualified midwives is essential for the future of midwifery.
Similarly, experienced midwives have been facing these pressures for years and ‘burning out’ is all too common often leading to reducing their working hours, sickness or leaving the profession; thus adding to the shortage overall.
The Royal College of Midwives (RCM) has been campaigning for more midwives and better care at least since I started my midwifery training in 2005. The latest recommendations concur with previous ones and can be found in ‘Getting The Midwifery Workforce Right’.
In 2015 the RCM suggested at least 2600 more midwives were needed in England. I fear this figure will have since risen.
As far back as 1993 the Changing Childbirth report advocated continuity of care for pregnant women and enough midwives to provide this care and yet this new report delivers the same message over 20 years later.
The real tragedy here is that women, their babies and families are suffering, as revealed by the NFWI and NCT joint report. If something drastic isn’t done to address midwifery numbers, then no amount of reports will help these women and babies that are facing ineffective and at times unsafe care.
Theresa Greenwood is a practising midwife and in-house midwifery advisor to the medical negligence lawyers at Slater and Gordon Lawyers in Manchester.