Socialist Worker

The growing crisis in midwifery is hurting pregnant women

by Sarah Davies
Issue No. 2039

Mothers’ and babies’ lives are being put at risk by staffing shortages in the NHS. Every day there are reports of women in labour receiving inadequate care as harassed midwives run from one birth to another.

One-to-one midwife care has long been accepted as the “gold standard”, since it reduces potentially dangerous interventions, such as caesarean sections, and results in a better experience for women.

In recognition of this, New Labour pledged that by 2009 every woman would have a named midwife to care for her during labour. This promise is sounding increasingly hollow.

At Northwick Park hospital in north west London an inquiry followed the deaths of ten women in three years. It identified “a catastrophic collapse of care” due to short staffing.

A recent survey by the Royal College of Midwives painted a picture of cuts, job freezes and midwife shortages.

Some 78 percent of maternity units in England had vacant midwife posts, while a third had had their budgets cut.


Sheila Shribman, the government’s maternity services “tsar”, recently said that child birth services should be rationalised in favour of fewer specialist centres.

Her argument is that “tough decisions” to close local units will ultimately result in better services. Shribman’s rhetoric is not based on any evidence.

A survey of ten European countries found that Britain, which has the largest maternity units in Europe, has the highest incidences of pregnancy care below the best standard.

The current wave of “rationalisation” is being driven by the lure of short term savings, as well as an ideology that bigger must be better.

In the north west of England a recent consultation advocated the closure of five maternity units – with no plans at all for extra midwives or birth centres.

This resulted in huge public anger. Local Labour politicians have found themselves in the contradictory position of having to be seen to support local campaigns, while still arguing that “tough decisions” must be made to improve services. Nationally, at least 20 popular birth centres are threatened with closure.


Privatisation by stealth continues. The “Jentle birth” scheme at Queen Charlotte’s hospital in west London offers a two-tier service.

For a payment of £4,000 a woman can be guaranteed one-to-one care at this large NHS unit. If you can afford it, you can have “gold standard” care.

But every woman should have the right to safe maternity care. One-to-one care is even more important for disadvantaged mothers.

The latest maternal mortality report identified that the most disadvantaged women were up to 20 times more likely to die as a result of childbirth than women from more affluent backgrounds.

In Manchester, following huge opposition, proposals to close five maternity units have been put on hold and referred back to health secretary Patricia Hewitt.

Health workers should not accept the dog-eat-dog approach fostered by the consultation in which individual units are pitted against each other.

We need to unite to fight for decentralisation. We need more birth centres and enough midwives to provide the care mothers and babies need.

Sarah Davies is a lecturer in midwifery at the University of Salford

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