Figures show Hewitt’s birth care promise is unattainable

Title: Figures show Hewitt’s birth care promise is unattainable.

Description:

Two-thirds of English regions do not have enough midwives to offer option of home delivery.

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Six out of nine English regions have too few midwives to achieve even the basic level of care for families before, during and after the birth of a child, figures obtained by the Guardian reveal. The chronic shortage of midwives means that the government’s promise this week to offer all women a choice of a home, hospital, or midwife-led birth by 2009 cannot be met. The Royal College of Midwives said that unless there was a radical recruitment programme – and an onus on health authorities to employ more midwives – the government’s plans to overhaul the service within three years would be thwarted. The health secretary, Patricia Hewitt, confirmed this week that the £1.7bn annual budget for maternity services would not be supplemented to see the plans through. Academics suggest that the government’s focus on choice could be misguided. Hull University research shows more women want a doctor and midwife team they can trust than wish to be able to make choices about their care. The Guardian obtained annual figures for the number of births each midwife has to deal with from detection of pregnancy to postnatal care. The statistics for England in 2005 were calculated from NHS data on the number of midwifery posts and Office for National Statistics numbers for births. The RCM says the maximum should be 28 births to a midwife in a year.

Actual ratios range from 1:38 in the east, to 1:15 in Yorkshire and the Humber. Of the nine English regions, only the north-east, north-west, and Yorkshire and the Humber achieve the RCM’s targets. Officials at the RCM who have seen more detailed government figures say that in the worst areas midwives are having to care for up to 42 women a year. Dame Karlene Davis, general secretary of the RCM, said: “With this situation women are not going to get the choices they’ve been promised. Some areas are struggling to provide even basic services. Vulnerable and disadvantaged women who need the most intensive support will suffer the most.” She said 3,000 more midwives were needed to carry out the government’s plans. The National Childbirth Trust lists 15 threatened or closed midwife-led birthing centres in England and four in Scotland. The centres are the cornerstone to the government’s promise of broadening choice but are also the most staff intensive. The Hull University survey followed 165 women through their maternity care and found that having the options of midwife-led care or a home birth had little impact on the psychological health of the women. Most expressed a desire for a trusted medical team led by midwives – particularly in the postnatal period. Some women even reported feeling they had “failed” to fulfil the choices they made. “The emotional ramification for some women of being robbed of the desired birth experience promised through choice was apparent,” the study says. “Choice as a single factor should not be accepted as enough to promote positive psychological outcomes. It seems rather that psychological health may be determined by the nature of their experience, the attitudes of the professionals they encounter, the relationships they build and the type and intensity of support that is offered.” A Department of Health spokeswoman said 80% of women were happy with their maternity services and there were almost 2,500 more midwives than in 1997, with a further 1,000 promised by 2009. “In some parts of the country we must and will do more, like developing more training places, bringing in flexible working and finding innovative ways to fill hard-to-fill vacancies. “Choice is about more than just receiving excellent clinical care on the NHS. It is about giving mothers-to-be a guarantee that the NHS will provide them with a full range of birthing choices, including a home birth, a midwife-led birth or consultant-led birth.”

Source:

http://politics.guardian.co.
Polly Curtis, health correspondent

Disclaimer:

Any views or opinions expressed are solely those of the author and do not represent those of The Federation of Antenatal Educators (FEDANT) unless specifically stated.