Employ more midwives

AIMS Journal, 2012, Vol 24 No 4

By Miranda Dodwell

National Federation of Women’s Institutes AGM – September 2012, London

I was somewhat surprised to receive a phone call from AIMS committee member, Debbie Chippington Derrick, asking me if I was able to attend the AGM of the National Federation of Women’s Institutes on behalf of AIMS. My mind flashed to my only experience of an NFWI AGM – scenes from the film Calendar Girls – and wondered what might be required of me!

It turned out that the NFWI was voting on a public affairs resolution on the employment of more midwives, moved by Horwich WI in the Lancashire Federation:

'There are chronic shortages of midwives. The NFWI calls on the Government to increase investment in the training, employment and retention of midwives in England and Wales to ensure services are adequately resourced and are able to deliver a high standard of care.’

A little bit of research told me that Professor Lesley Page, President of the Royal College of Midwives, was to debate the issue with Nick Bosanquet, professor of health policy at Imperial College, London.

On arrival at the Royal Albert Hall, I was shown to the press box and saw the venue was full to bursting with WI members of all ages. I was just in time to hear their guest speaker, Lord Julian Fellowes, speaking most amusingly about his admiration for strong women, and how they had influenced his portrayal of characters in such successes as Gosford Park and Downton Abbey.

The resolution on employment of more midwives was then proposed by Susan Baines, who is both a midwife and a WI member. She explained that midwives are the experts in normal childbirth, but their role is becoming ever more demanding and complex due to the impact of social change, increasing immigration, poverty and social deprivation combined with new technologies and the reduction in junior doctors’ hours. At the same time, the birth rate continues to rise and midwife numbers have not kept up, resulting in increased numbers of operative births. Sue also described how midwifery support is important both for safety of women and for their satisfaction with their care which helps them become more effective parents.

Lesley Page then took the stand to give her support and that of the RCM to the resolution. She agreed with the proposer’s view that having enough midwives to support women was important both for women’s safety and to put them on the right path to parenting. She acknowledged the increase in the number of midwives over recent years: 2,500 more under the previous government and almost 1,000 under the current government, together with increases in places for student midwives. However, she told the WI members that this has to be seen in the context of the rising birth rate. Between 2001 and 2010, the number of babies born in England rose by an astonishing 22%, with that rise predicted to be 28% by 2015. In Wales, the birth rate rose 19% between 2002 and 2010 but the country now has its lowest number of midwives since 2003.

Not only are there more women giving birth, but those women now tend to be older, more ethnically and socially diverse and with more multiple pregnancies due to increases in fertility treatment. Without an increase in the number of midwives the safety of women and the quality of the care they receive will be compromised.

In Lesley’s view, there is a real risk that safety of birth for both mothers and babies would be compromised without more midwives available to provide one-to-one care and a minimum ratio of one midwife to every 30 births.

The single most important thing the Government could do, she continued, would be to increase the number of training places for student midwives. Further ways to improve the situation would be for more births to take place in out-of-hospital settings, such as at home and in midwife-led units, and for appropriately trained and supervised maternity support workers to perform some tasks traditionally under taken by midwives.

She concluded by saying that scrimping on midwifery services in the short term would short-change the next generation, but investing in the start of life would pay rich dividends.

Professor Nick Bosanquet then spoke opposing the resolution. His stance was that investment in training was a long-term answer and that more immediate solutions were needed. He set out six steps that would help midwives in the short term and reduce variability in the quality of care:

1. More support for units that face problems, including setting up networks between them and units achieving good results.
2. Improving the information base so we can more readily identify the units that need most help.
3. Increasing support and training for qualified midwives to feel more confident in their skills.
4. Ensuring that women have a named midwife to increase continuity of care.
5. Increasing links with the voluntary sector such as Netmums, Mumsnet and 4Children.
6. The Women’s Institute to play an important role in adopting local units, showing support and fundraising for equipment.

Professor Bosanquet’s last step did not go down well with the WI audience who, I assume, found his attitude towards them somewhat patronising. He began to suffer the same fate as Tony Blair in 2000 – the WI slow handclap. He wrapped up his speech quickly and sat down.

Points were then taken from the floor, both supporting and opposing the resolution. Some questioned where the money to fund this resolution would come from, with concern that it would be taken from other NHS services which also badly needed funding. There was support for home births and midwife-led units, but a concern that these services were being cut rather than supported. There were questions about how midwives could be retained within the service, and how experienced midwives who were retiring were going to be replaced. WI members who were also midwives spoke about how difficult it could be for qualified midwives to find jobs, and how the job was so difficult because it was so busy and there was a lack of support.

The resolution was then voted on, and the result announced later in the day. 96% of members had voted in favour of the resolution which will now become the campaigning focus for the next year.

Although my business was over for the day, I was invited to stay on for the rest of the AGM and I am so glad I did. It involved an attempt at the world record for the largest number of knitters in one place; a presentation from the remarkable space scientist Dr Maggie Aderin-Pocock, born in Britain to Nigerian parents and brought up on a council estate, who spoke to the WI carrying her two year-old daughter in a sling; dancers from Strictly – Robin, Kristina, Artem and Kara – previewing their new show; and finally the very moving ‘Jerusalem’ and Welsh national anthem sung by the entire hall. I left clutching some WI biscuits and jam, full of admiration for this group of amazing women.