The BBC called NCT’s press office yesterday to see if we’d comment on its new research. It had found that tens of thousands of mothers and babies in England were harmed by potential lapses in maternity care in the past two years.
In fact, the research revealed that the number of incidents logged by worried hospital staff was the equivalent of one mistake for every five births.
Unfortunately, this news confirmed my concerns. The BBC figures echoed our research (conducted with the National Federation of Women’s Institutes, NFWI) earlier this year, which found that 50% of women experienced ‘red-flag events’ on labour wards.
‘Red flag events’, according to NICE, are signs that there may not be enough midwives available to give women and babies the care they need, for example having to wait more than 30 minutes to get pain relief or over an hour to be given stitches.
Our report, ‘Support Overdue: Women’s experiences of maternity services 2017’, is the second NFWI and NCT have produced and our latest findings suggest little progress has been made in the four years since the last publication.
So the new BBC figures were hardly a shock and we gave them the quote: “Maternity care is in crisis, staffing levels are dangerously low and midwives are being stretched to the limit.”
Did we go too far by using the word ‘crisis’? I don’t think so. Despite the vast majority of women in the UK having a good experience of maternity services, too many are still receiving substandard care. And the impact on physical and emotional wellbeing is significant.
We also called on the Government and the NHS to end the chronic midwife shortage. There is an estimated shortage of 3,500 midwives in England alone.
Women have told us that midwives are working hard to do the very best that they can, but that there are simply not enough of them to go around. This shortage must be addressed and action taken to implement NICE guidelines on safe staffing in maternity settings.
But providing more midwives will not solve the complex problems on our maternity wards. The way that midwives work must change radically too.
We think that many of the problems that currently exist in maternity services could be addressed through better continuity of care. This is a system where a woman is supported by a midwife, small team of midwives and/or a clinical team that she knows and trusts throughout her pregnancy and afterwards.
Continuity of care enables midwives to have the time build a relationship with women and their partners to understand and meet their needs throughout pregnancy and afterwards. Women report greater satisfaction with information, advice, and choice of pain relief for example. They are also more positive about their overall birth experience, with an increased sense of control and less anxiety.
Importantly, continuity of care results in better outcomes for women and babies: women who received it are less likely to give birth prematurely, less likely to lose their baby during pregnancy and more likely to have more straightforward births than those receiving standard care.
Numerous studies have shown that continuity of care does not cost any more than running a properly staffed standard system, partly because of the cost savings made as a result of more straightforward births and shorter hospital stays.
It also leads to higher levels of job satisfaction for midwives and lower levels of burnout. So adopting this system could help to stem the flow of midwives leaving the profession due to their disillusionment with the current state of play.
It is timely that this week also saw NHS England publish new guidelines on ‘Implementing Better Births: Continuity of Carer’ to help Local Maternity Systems put continuity of carer in place within their services.
Making continuity of care a reality is a huge opportunity to work towards safe and high quality maternity care for women and babies - a change long overdue to lessen the number of crises on our maternity wards.