A WOMAN conceiving a child this month will give birth to her baby in a new era of choice for maternity care in England. The Government has said that “Maternity Matters” – its maternity care policy, launched in April 2007 – and guaranteed that, by the end of this year, England’s National Health Service will deliver a world-class maternity service to all new mothers.
Indeed, Labour committed itself in both its 2001 and 2005 general election manifestos to improving maternity services. The 2005 manifesto said: “By 2009, all women will have choice over where and how they have their baby and what pain relief to use. We want every woman to be supported by the same midwife throughout her pregnancy.”
With nine months to go before the policy comes into effect, what is the big picture? The policy is good, but the picture is patchy in the regions – especially in terms of the promised funding for maternity care trickling down at a local level. We in the Royal College of Midwives believe that our members will struggle to provide women with one-to-one care by 2012, even if Government hires an extra 3,400 midwives, as promised by Secretary of State for Health Alan Johnson last January.
NHS workforce documents obtained by the RCM show that, even with these extra midwives, six out of the 10 English strategic health authorities will not meet the recommended annual midwife-to-births ratio. In order to give women the best quality care, the RCM recommends that maternity units annually need one midwife for antenatal and postnatal care for every 28 births. However, some regions will see a midwife dealing with up to 36 women. This is despite the projected increases in hiring more midwives.
The RCM believes that an extra 5,000 full-time midwives are needed to deliver safe, high-quality care and meet the Government’s national choice guarantees set out in Maternity Matters, its programme for improving choice, access and continuity of care in maternity services – especially as we are facing a rising birth rate. The Government’s guarantees include choice of how to access maternity care, choice of type of antenatal care and choice of place of birth. Depending on their circumstances, women and their partners will be able to choose between three different options, including a home birth, birth in a local facility – including a hospital and under the care of a midwife – or birth in a hospital supported by a local maternity care team.
We know the Government is making a big effort to recruit more midwives and is putting money into maternity services. Last January, ministers promised £330 million for maternity care by 2012. The Government’s policies are to be applauded and it is going in the right direction to empower women and give them more choice during childbirth.
Nevertheless, the NHS staff projection figures show that, although the situation for most regions will be better, it will still not be good enough to deliver the quality of maternity care that women need. A sea change is required at both regional and local level to recruit more midwives. We hope that regional decision-makers will take responsibility for this, treat it as a priority and actually put the money they have been promised for maternity services into them.
The Government has made guarantees about what NHS maternity care in England will be like by the end of this year. We hope that these guarantees are met. It is what women have been promised and, quite frankly, what they deserve.
Cathy Warwick is general secretary of the Royal College of Midwives
