Maternity underfunding means care based on what trusts can afford not on women’s safety and needs says RCM

By RCM on 18 March 2022 RCM Women Wellbeing Of Women Maternity Safety Safety Midwife Shortage NHS Staff Staffing Levels MSWs - Maternity Support Workers Midwifery Workforce Government

The Royal College of Midwives (RCM) is calling out the Government’s record on maternity funding which leaves some NHS trusts and boards basing midwifery staffing levels on what they can afford, not women and baby’s needs. Delivering the safest possible care for women and babies must be the driving force behind maternity service funding says the RCM outlining its position on safer staffing.

Rising demands on maternity services are colliding with years of underfunding to create a perfect storm of factors affecting maternity safety and quality. England has a chronic shortage of over 2000 midwives and the situation is deteriorating with midwife numbers falling month on month, worsened further by pandemic related staff sickness and absences.

Other UK countries are also starting to feel the worrying bite of staffing shortages. This is all having an impact on the safety and quality of care for women, and also means many women with more complex needs such as mental health problems are not getting the care they need and deserve. This is also leaving staff exhausted, overwhelmed, fragile and feeling massively undervalued warns the RCM.

Birte Harlev-Lam, Executive Director, Midwife at the RCM said: “Women and their safety are still not being put at the centre of care. If this was the case, we would see significant amounts of additional funding and real efforts to support, retain and recruit staff, and we are not. There is a black hole in the centre of our maternity services where more money and staff should be. I have no doubt this is undermining maternity staff efforts to deliver the safest and best possible care for women and their babies.

“We know also that many staff are still afraid to speak out when they know something is wrong for fear of reprisals and recrimination. We must flip this thinking where it happens on its head. Every workplace must have a culture that encourages and supports staff to raise their voice, and then acts on it, because they will be the ones delivering the safest care.”

The RCM is also raising a red flag over concerns that regular reviews of staffing levels are not happening often enough. This is particularly crucial when making major service changes such as delivering more personalised care for women. Trusts and boards should also have escalation plans that kick in when demands on services exceed their capacity to meet them says the RCM.

More specialist midwifery roles that play a key part in delivering safer and better care for women are also needed. These offer additional and tailored support for women with more complex problems such as mental illness, and physical problems that can affect their pregnancy.

Northern Ireland, Scotland and Wales are also feeling the worrying impact of understaffing as pressures on services increase. Across the UK these shortages have been deepened by several factors including limited opportunities for flexible working. This is damaging the attractiveness of midwifery as a career option says the RCM.

Birte Harlev-Lam added, “Staff are working even harder and then harder again to continue delivering the safest possible care. They can only do this for so long before they and the system relying upon those efforts breaks, and I think we are close to this. We must see urgent investment in midwives, maternity support workers and doctors. We must once and for all see governments really solve maternity staffing shortages and invest in services now and for the long term. Failing to do this means less safe care for women and babies, and intolerable and unsustainable pressures on staff, both of which are the very opposite of what we all want to see.”


To contact the RCM Media Office call 020 7312 3456, or email [email protected]. 

Notes to Editors: 

The RCM’s Safer Staffing Position Statement can be read at

See also RCM calls for a seismic NHS cultural shift to improve maternity safety and RCM warns of midwife exodus as maternity staffing crisis grows.

The Royal College of Midwives (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 | A professional organisation and trade union dedicated to serving the whole midwifery team