Some Facts ...

AIMS Journal, 2010, Vol 22 No 1

Compiled by Jo Murphy-Lawless

• British maternity services are running short of 4,000 midwives at present. The Royal College of Midwives states that 'England will still be suffering a severe lack of midwives by 2012 even if Government recruitment targets for an extra 3,400 midwives are met'. ¹

• Intervention rates are rising inexorably, Caesareans now stand at 24.3% nationally. This is costly as well as poor practice. Hospital Trusts are paid £2,579 for each Caesarean section compared with £1,174 for a normal midwifery-led birth. They are paid £3,626 for a Caesarean with complications. Taxpayers fund the excessive rates of Caesareans. The WHO states a Caesarean rate of over 15% is associated with more deaths and ill-health than health gains.

• The lack of midwives is leading to a significant number of women being left without the support they feel they require. In the Healthcare Commission's 2008 report, Towards better births: a review of maternity services in England, 25% of women stated they had been left alone during labour at a point when they felt anxious. ²

• In badly over-stretched, under-resourced maternity services, there are increasing concerns about 'near misses', the numbers of poorer outcomes linked to extensive obstetric interventions, and less than optimum care. An independent inquiry in 2008 reported that an estimated 62,746 safety 'incidents' were recorded in English maternity units in a twelve-month period between June 2006 and May 2007, with moderate harm in 11% of cases (6,902); severe harm in 1.5% of cases (941) and death in 0.5% of cases (314 deaths). ³

• The Albany Midwifery Practice in Peckham, south London, has been providing safe, woman-centred care for women from deeply disadvantaged backgrounds for twelve years. The Albany has been thoroughly evaluated twice, it has a far lower Caesarean section rate than King's College Hospital and a far lower perinatal mortality rate.

• The Albany gave genuine choice to the women and babies whom it served about place of birth and choice of midwife at birth. National maternity policy states that all women should have a choice by 2009. In October, 2009, the National Childbirth Trust released a study showing that less than 5% of pregnant women in the UK are free to choose where to have their baby.⁴

The Albany provided safe, woman-centred care for vulnerable women who want and depend on this care for themselves and their babies. Yet King's has forced the service to close down and limited its continuity of care. Why are women being denied safe birth in one of the few pockets of genuine woman-centred midwifery-led care in Britain?

References

1. RCM press release 16th April 2009
2. Healthcare Commission (2008) Towards better births: A review of maternity services in England. www.cqc.org.uk/_db/_documents/Towards_better_births_200807221338.pdf
3. O'Neill, Onora et al. (2008) Safe Birth, Everybody's Business: An independent inquiry into the safety of maternity services in England. London: King's Fund. www.kingsfund.org.uk/research/publications/safe_births.html
4. Dodwell, Miranda and Gibson, Rod (2009) An Investigation into Choice of Place of Birth. London: National Childbirth Trust www.nctpregnancyandbabycare.com/choice