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Midwife numbers do matter says RCM on King’s Fund report

Sunday, 6th March 2011   

The King’s Fund report ‘The Maternity Workforce’ published today (Sunday, 6th March 2011) is a welcome report which makes a valuable contribution to the ongoing debate about the maternity workforce, says the Royal College of Midwives (RCM). It argues that maternity services need to be organised effectively, and the RCM has consistently stressed the need for this.

Cathy Warwick, General Secretary of the Royal College of Midwives, said: “There is no doubt that maternity care like the rest of the NHS is looking into a storm of possible cuts to services. I am here to warn of the folly of such a course. The birthrate is showing no sign of changing from the historically high rates we are seeing. Births are becoming increasingly complex adding to the demands on midwives’ time, and midwife numbers have simply not kept pace to cope adequately.”

The RCM also agrees that midwives can take on new roles such as examination of newborn babies. However, the RCM stresses that these roles should only come if they improve the quality of care for women. Also, these new roles should not be added at the expense of the essential care many midwives are currently struggling to provide because there simply are not enough of them to deal with their current workload.

The RCM also has concerns about suggestions for other health workers taking on roles in maternity care. This can be appropriate and happens already with for example maternity support workers supporting breastfeeding and care of newborn babies. The RCM is adamant however, that you cannot compensate for not having the right number of midwives by transferring care that only midwives can and should provide, to other members of staff.

The report’s focus on labour and birth may also deflect from the pressing need for good quality antenatal and postnatal care. Two recent reports from CMACE and the West Midlands Perinatal Institute specifically addressed the importance of good care in these periods.

The CMACE report also highlighted that the leading cause of maternal death was infection, often developing after the birth. This positively puts out the message that regular postnatal visits from midwives are essential. The RCM has heard about postnatal visits being cut to as little as two visits because of staffing issues. Here is one concrete and specific example of how having the right number of midwives to ensure the right number of postnatal visits will improve safety.

Cathy Warwick added: “It is difficult, if not impossible, to re-organise your workforce if you do not have enough of them in the first place.  Midwives, support workers and other personnel are all needed to provide a safe and high quality service that offers women the choices they have been promised, and to give them safe and high quality care. As this report says, you need the right numbers of staff, in the right place at the right time. Anything less fails women, will lead to inadequate care and may possibly even endanger their safety.”


 For more information contact the RCM Press Office on 020 7312 3456, pressofficer@rcm.org.uk.

Notes to editors

The Royal College of Midwives is the voice of midwifery. We are the UK’s only trade union and professional organisation led by midwives for midwives. The vast majority of the midwifery profession are our members. The RCM promotes midwifery, quality maternity services and professional standards. We support and represent our members individually and collectively in all four UK countries.  We influence on behalf of our members and for the interests of the women and families for which they care.  For more information visit the RCM website at www.rcm.org.uk.


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