Today I will be in Parliament to launch the latest edition of the RCM’s State of Maternity Services Report.
What has stood out for us as we looked through all the many numbers and statistics we have collated for this report is the changing demographics of both midwives and mothers. In particular what we noticed is the ageing of both groups.
Take England as an example. There has been a big jump in the number of midwives during this decade, which is great. But when you dig a little deeper you see that the number of midwives aged under 50 has actually fallen; the entire rise is made up of older midwives, i.e. those near retirement.
These older midwives are providing excellent, valuable service, with many years of experience and knowledge. They are a credit to the NHS, and their contribution changes lives for the better every day. But it is an unavoidable fact that they will need to be replaced fairly soon as they edge towards taking their well-earned retirement.
Almost 1,100 NHS midwives in England are in their sixties, and overall a third of midwives in England are in their fifties or sixties. And it is not just a challenge facing the health service in England; in fact, the situation is more pronounced in the other parts of the UK.
In Wales, just over a third of midwives (35%) are aged at least 50. In Northern Ireland, it is two midwives in every five (40%). And Scotland is the part of the UK with the largest proportion in their fifties or sixties: 1,432 midwives and maternity care assistants there are in this age bracket, making up 41% of the workforce.
I want to emphasise that these midwives are making a real, positive difference to the lives of women and families every day. But we need to train and recruit their replacements now, well ahead of such a big chunk of the workforce reaching retirement age.
In terms of staffing, maternity services in England face the biggest challenge, with a shortage of around 3,500 midwives. And of the midwives that there are in England, over 1,300 come from elsewhere in the European Union; as things stand right now, they do not know whether they will have the legal right to be here a few years from now. And all of that is in addition to the challenges presented by the age profile. You can see how it is challenge piled upon challenge when it comes to staffing.
The demographic profile of the women accessing maternity care is ageing too. In Northern Ireland, births to women in their thirties are up almost 3,000 since the start of the century, with births to those under the age of 25 down around 1,000. In Wales, births to women aged 40 or above have now passed the 1,000 mark.
In Scotland, the age group that has seen the biggest jump in births is women in their late thirties – up 2,000 since the year 2000. And in every region of England, since 2001, births are down for women under the age of 30 and up for women who are 30 or older; overall, there has been a rise of over 12,000 in the number of babies born to women aged at least 40.
These women expect, need, deserve and are entitled to the care they receive. The reason we draw attention to this trend is simply because, on average, they will need more care during their pregnancy than younger women. That means we need more midwives to provide the care needed as the demographics of the women accessing maternity services change.
Particularly in terms of the age profile of the profession, we need action now – in Northern Ireland, Wales, Scotland, and England – to train and recruit into the service more new midwives. They need to be in post before our older midwives leave employment through retirement. That is not something for which there is a quick fix; it is something that needs to be addressed now. That’s what I will be telling the MPs and peers I see in Parliament today.