Ahead of a controversial programme that will reveal how maternity services in London are struggling to cope with increasing birth rates and a shortage of staff, the Royal College of Midwives has told The Huffington Post UK that the government must support an increase in funding.
An independent review conducted for NHS London, which has been leaked to the BBC's Panorama, found that substandard maternal care was a major factor in 17 deaths across London between January 2009 and June 2010.
The BBC investigation found that maternity units closed 1,055 times in 2010 due to under-staffing and a lack of beds. At least 927 women were turned away, the programme said. Barnet Hospital in London closed 102 times, the most of any ward in the country.
Jacque Gerrard, director for the Royal College of Midwives UK Board for England, told The Huffington Post UK that midwives felt unable to provide the standard of care that they are trained to provide.
"They're feeling extremely over stretched," Gerrard said. "The standard that we are aiming for is one-to-one care . When we speak to women they tell us that they can see midwives are extremely busy. Women feel guilty, even embarrassed at times to ask for information or advice because they can see that the service is stretched."
Closing wards due to under-staffing or a lack of beds is a last resort and is usually not a safety issue, Gerrard said. "But from the woman's experience perspective, and from the perspective of the midwife, they're already dissatisfied because the women want to give birth to their babies in the local maternity unit. They don't want to be transferred out of the area."
The Royal College of Midwives estimate that 4,700 midwives need to be added to the NHS just to keep pace with rising birth rates. It says that the birth rate has risen more than 20 per cent in ten years, and is rising faster each year. However increases to midwives promised by Prime Minister David Cameron in opposition have not materialised.
Panorama found that the average midwife vacancy rate in England was five per cent, but was as high as 20 per cent in some London trusts. However the Royal College of Midwives said the problem was still one of funding, because posts were not available evenly across the country.
"We need 4,700 midwives to keep standing still and provide safe maternity services. It's an issue of funding," Gerrard said. While the government have supported midwives' training, and while there are up to 300 applicants for each training course in some areas areas, "when [students] come out there aren't the jobs for them in the NHS".
Compounding the problem is the fact that the age of midwives is fairly high, and that many will retire before changes to NHS pensions are made as a part of wider coalition reforms.
Gerrard said: "If Mr Cameron went back to the promise of 3,000 midwives that would be a huge surge of midwives into maternity units and into the community and standards of care would improve. Women would be satisfied, outcomes would be positive and hopefully we wouldn't be getting the situations that we may be seeing in Panorama."
However, Gerrard added that women who watch Panorama should not panic. "The last thing we want to do is scaremonger. We want women to know they can trust their midwives. If there are any problems contact your midwife and they will explain the situation at a local level," she said.