Midwife shortages and NHS cuts have been big news recently. Our midwife explains how they’ll affect your care
Before he came into power, David Cameron pledged to increase the number of midwives in England by 3,000, saying: “We are going to make our midwives’ lives a lot easier. They are crucial to making a mum's experience of birth as good as it can possibly be, but today they are overworked and demoralised.”
Unfortunately, we have yet to see this promise materialise. Together with England’s increasing birth rate, which has risen 22% in the past two decades, and pregnancies becoming more complex due to problems such as obesity and diabetes, there’s more pressure than ever on maternity services.
It’s normal to feel a little worried about how this will affect you as a mum-to-be, but it’s also important to remember that maternity units will vary hugely around the country, with some in crisis and some not. And no matter where you live, there’s still lots that you can do to get the best out of your maternity care – and help us to help you, too.
If your pregnancy is low-risk, you should have a minimum of 10 antenatal appointments with your midwife, or seven if you’re a second-time mum. If there’s a shortage of midwives, you might find there’s a lack of continuity in your care and a different face each time you go for check up. This isn’t great, as it’s good to build up rapport with your midwife. But ultimately what’s important is that your care is good quality, whether from one midwife or 10.
One-to-one care in labour produces better outcomes for both mum and baby. You need to feel safe during labour, and any problems are more likely to be picked up early if you have close and high-quality care. Being supported will also help you relax, which in turn helps the uterus and cervix (both are made of muscle) to work more efficiently. Imagine running a marathon with stiff, straight legs – it just wouldn’t work! Although maternity units aim to provide one-to-one care, this often isn’t possible.
If a maternity unit is busy then you may not have the option of an epidural. This is because an epidural means you’ll need one-to-one midwifery care and if this can’t be provided, then neither will the epidural. Also, if a busy maternity unit only has one anaesthetist, he or she could be in the operating theatre a lot of the time, providing pain relief to women having a c-section and therefore be unavailable on the labour ward.
According to the Government guidance report Maternity Matters, women should have the choice of a midwife-led birthing unit, a consultant unit or home birth. The reality is that not all women have this choice as some local birthing centres, such as Heatherwood Hospital’s Ascot Birthing Centre in Berkshire, have closed due to staff shortages, and home birth services in some areas are stretched as community midwives get called to the labour ward to support the unit. With the Government aiming to make £20bn of savings in the NHS, the Royal College of Midwives (RCM) has warned that services will be further affected if already short-staffed maternity units are expected to reduce staff numbers even more.
You can visit nhs.uk to find out what your local maternity unit has to offer, and then contact them to find out the midwife-to-woman ratio, or arrange a look around.
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