Give midwives the autonomy and the flexibility they need to support vulnerable women, says RCM

By Give midwives the autonomy and the flexibility they need to support vulnerable women, says RCM on 23 November 2020 RCM Maternity Services NHS Staff Safety Pregnancy Women Midwives Specialist Midwives Government RCM CEO Perinatal Mental Health Maternal Mental health Alcohol and pregnancy Domestic Abuse Disabilities Expectant Mothers

A leading Royal College has called for greater support to be given to vulnerable women during pregnancy. The Royal College of Midwives has warned that, without appropriate support, women with severe and multiple disadvantage are at greater risk of poor outcomes in pregnancy.

Women who are in abusive relationships, have experienced childhood trauma or have mental health problems are among those at greater risk. While midwives can be extraordinarily effective in identifying needs and advocating for women. Their effectiveness is often hampered by a lack of resources and professional support. This must be addressed if midwives are to give women experiencing severe and multiple disadvantage the level of integrated support they need, to lessen the risk to them and their babies.

Gill Walton, Chief Executive of the Royal College of Midwives, said:

“Midwives are in a unique position to support and signpost women to access the right services for them, and we know that, when they’re able to do so, the outcomes for women and their babies is infinitely better. Too many women face barriers to accessing the right care and support during pregnancy, and that has potentially tragic implications. Yet the answer is a really simple one: give midwives the autonomy and the flexibility they need to support vulnerable women.”

The RCM is calling on all UK NHS bodies to adopt its five-point plan:

  1. Midwives are afforded autonomy and flexibility when caring for women experiencing severe and multiple disadvantage
  2. Midwives are given additional support to navigate services for women experiencing severe and multiple disadvantage
  3. Midwives are appropriately trained to support women experiencing severe and multiple disadvantage
  4. Midwives are supported and empowered to work in partnership and with the same women where possible.
  5. The health, safety, and wellbeing of midwives is protected when caring for women experiencing severe and multiple disadvantage

The RCM believes that, if these changes are achieved across health care systems, women will have substantially better outcomes.

When Julie (not her real name) was pregnant, she was dealing with a number of different issues that could have impacted on her own health and wellbeing, and that of her baby. She recognises that midwives often struggle to be heard by other services and the impact that has on them.

“I had two midwives and they were really fantastic. Both of them were working together because I had many complications – housing, mental health, and they worked to arrange and rearrange the appointments I needed. But it wasn’t easy for them, I could see they were trying but often services wouldn’t listen, and I could see they took on a lot, it cost them.”

Gill Walton added:

“Many midwives are already going above and beyond to secure the right support for the women in their care, including working with other agencies. Unfortunately, all too often they’re working in maternity departments that are already severely stretched, which can mean they aren’t always able to offer the wraparound care that some women need, causing some to fall through the cracks. We need a commitment from the Government to fund maternity services properly with staffing levels that mean women get the care they need at a time when they may be at their most vulnerable.”  

Read the position statement here.


To contact the RCM media office call 020 7312 3456 or email [email protected]

Notes to Editors

The RCM is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team. We provide workplace advice and support, professional and clinical guidance, and information, and learning opportunities with our broad range of events, conferences and online resources. For more information visit the RCM website at