Getting the right start in life

By Head of Health and Social Policy Sean O'Sullivan on 25 May 2022 Pay Midwives NHS Pay Review Body NHS MSWs - Maternity Support Workers Caring For You campaign Pay and Agenda For Change Race matters TUC

Last week the RCM’s Head of Health and Social Policy Sean O’Sullivan joined a Labour Party roundtable discussion with Shadow Secretary of State for Health and Social Care Wes Streeting to highlight the invaluable contribution midwives have when it comes to supporting women and their babies to get the right start in life. In his latest blog, Sean shares what he presented at the roundtable.

The health of mother and baby, and early child development, are vitally important influences on life chances. Interventions such as breastfeeding, smoking cessation and parental emotional wellbeing can have a positive and far-reaching impact on a child’s development. Pregnancy is a key time to explore lifestyle choices as women and families are likely to be particularly receptive to making positive health choices.

Conversely, it is often during pregnancy and early childhood that families get locked into the intergenerational cycle of inequality. For example, babies born to families on lower incomes are significantly more likely to be born underweight; and lower birth weight babies have higher risks of mortality and of experiencing developmental problems.

Midwives have a strong part to play in strengthening individuals, families and communities while at the same time giving good advice and support. Among health and care professionals, midwives are particularly trusted and adept at building relationships with women and so are well placed to engage with those that need the most support.

It is therefore no surprise that Michael Marmot has argued that midwifery should be central to public health and prevention policy, because at its heart is the goal of giving every child the best start in life.

Unfortunately, while midwives know how to make public health interventions, their potential and actual contribution is often overlooked. What is striking about public health policy and prevention strategies over the last 20 years, is how often midwifery is absent from the picture.

All too often, capacity issues and time constraints mean that midwives have insufficient time with every woman to talk through ways in which she can improve her health and the health of her baby. Midwives can also be held back by lack of readily identifiable community bases that are easily accessible to women. These are all missed opportunities.

Therefore we would like to see the development of public health, prevention and early years policies that are based around:
• Harnessing the skills and expertise of all clinicians in the delivery of public health, including midwives.
• Locating health and care services, including midwifery, in easily accessible and prominent community facilities.
• Recruiting and retaining more midwives, to create the space in which midwives can spend more time speaking with women about how they can improve their own health and that of their baby.
• Allow public health programmes sufficient time to bed in, recognising the value of short-term investment for long term gain, and to therefore resist the pressure to scrap schemes or downplay policies when they don’t deliver overnight results.

We are not getting early intervention right, as evidenced by cases of child maltreatment, poor health outcomes – the evidence is stacking up that early intervention and prevention policies are not working as they should.

When done right, early intervention is not only crucial to the health and wellbeing of women, families and children. It is good for community cohesion and economic productivity as well as leading to savings in the costs of mental illness, unemployment, crime and the other expenses associated with unequal life chances.

Midwives are crucial to the success of strategies to promote health and wellbeing and to tackle inequalities during pregnancy, birth and the postnatal period. So our message to decision-makers across the UK is that it is time to acknowledge the contribution that midwives can make.