Together we stand for maternity services: a glimpse into the current crisis

By Suzanne Tyler RCM Executive Director, Trade Union on 23 February 2023 Maternity Services RCM Trade Unions TUC

Seven maternity units across England in three-and-a-half days – tertiary units, mid-sized units, relatively new builds and some real vintage estates. Everywhere I went, midwives and maternity support workers (MSWs) continue to put women first and pull out all the stops to provide high quality sensitive and compassionate care.

I feel humbled to have met so many committed and passionate RCM members. But none of these units were anywhere near fully staffed and, in many, vacancies are being exacerbated by high rates of staff sickness and maternity leave resulting in those services being unstable and vulnerable. I saw units closed due to staff shortages (stand alone units long since closed), support workers being pressed into inappropriate clinical roles, students who are certainly not supernumerary, reduced and limited PMA capacity to offer support, high levels of workplace stress - and sadly many, many tears.

I saw managers trying their best to find ways to cover services, sometimes imaginatively and sometimes desperately. Short-term measures often have unintended consequences, like the unit where community midwives have all left their substantive contracts and now work permanently on the bank in order to avoid an ill thought-out on-call rota. I heard the same story somewhere else, where it was fear of being forced into continuity teams that was driving people to work as bank. For many it makes economic sense to reduce contracted hours and work on the bank – just another consequence of the Westminster Government’s refusal to deliver a decent pay deal. This all makes it even harder for managers to cover all shifts and it costs the NHS even more money.

Units where the estate is tired and cramped and the midwives’ only break room is also an office and filing cupboard contrast with a newer build where our rep has secured space for a wellbeing room with bean bags, comfy chairs, a microwave and now sessions with massage therapists. The relaunch of our Caring for You campaign is a great opportunity for addressing the small changes that can make a difference – making sure everyone gets to take a break and that they have somewhere comfortable to take it and that everyone has access to psychological and wellbeing support when the day is particularly tough.

I saw the difference that visible and engaged midwifery management makes and heard from Directors and Heads of Midwifery who stand up for their staff and powerfully advocate for over-recruiting to smooth out vacancies, for roles that provide leadership, specialist support and career development opportunities.

I saw the difference that supporting newly-qualified midwives can make and I talked to students who will vote with their feet, choosing to work at units that offer them a supportive and developmental working environment. Local RCM reps everywhere are doing an amazing job in raising collective issues, supporting individuals, building a sense of community and solidarity. The RCM branch is the safe space. Our regional officers and organisers are committed to being back out in units, listening to stories, sharing advice, galvanising action and building active branches.

What worries me most is that short staffing has become the norm and there is a growing sense of resignation that nothing can change. Working beyond shift, usually unpaid, is routine. And this is what is driving midwives and MSWs out of the NHS.

This week has only confirmed that we can draw a straight line from pay to staffing levels to job satisfaction and through to safety. We cannot afford to lose a single additional midwife or MSW. Increasing student numbers and international recruitment have their place but the biggest priority for the NHS must be to find ways to keep every midwife and MSW we already have. This will be the RCM’s message in every forum we have locally, regionally and nationally. It’s the story we will tell the media, politicians and partners and allies.

I talked to midwives who still feel the joy and pride that comes with the work they do, whose first thought is always ‘what about the women?’.  It’s the message I have taken straight to the Pay Review Body. It’s not that goodwill is being withdrawn, it’s just that we’re nearing the bottom of reserves. There’s almost nothing left to give and that’s why being a member of a union is so important. Together we stand for fighting unfairness, collaborating on solutions and protecting each other in order to protect women and babies. Together we stand for better maternity services and better working conditions – now is the time to get active in your RCM, your union.