Worrying that so few women are seeing the same midwife or groups of midwives say RCM on new report
By RCM on 09 August 2017 Report RCOG - Royal College of Obstetricians and Gynaecologists Maternity Unit Closures Midwives Staffing Levels Midwife Shortage NMPA - National Maternity and Perinatal Audit Maternity Services RCPCH - Royal College of Paediatrics and Child Health
A new report by the National Maternity and Perinatal Audit (NMPA) has found a large increase in midwife-led units* co-located with obstetric units that has increased birthplace choice for women.
The National Organisational Report 2017 also describes how maternity and neonatal care is provided across England, Scotland and Wales.
The report itself was commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme, the National Maternity and Perinatal Audit (NMPA) is the largest evaluation of NHS maternity and neonatal services undertaken in Britain.
It aims to help maternity services to identify good practice and areas for improvement in the care of women and babies.
Launched in 2016, the NMPA is collaboration between the Royal College of Obstetricians and Gynaecologists (RCOG), the Royal College of Midwives (RCM), the Royal College of Paediatrics and Child Health (RCPCH) and the London School of Hygiene and Tropical Medicine.
The first report from the audit provides comprehensive information on how maternity and neonatal care is delivered by the NHS in England, Scotland and Wales. This includes maternity and neonatal care settings, availability of services and facilities, and staffing.
Responding to the report, Mandy Forester Head of Quality and Standards at the RCM says; “This is an important report that the RCM very much welcomes. There is much to be optimistic about, but it also throws up some issues of real concern.
“The RCM is encouraged to see many women getting 1 -to-1 care in labour, but want to see this at 100 percent.
“We do however have concerns about what services maybe being affected to ensure 1-to-1 care actually happens, as this could potentially be at the expense of midwives being pulled out of community services as well as it affecting areas such as home births and vital postnatal care because of existing midwife shortages.
“It is worrying that so few women are seeing the same midwife or group of midwives. Continuity of carer is crucial to ensuring safe, high quality care. Another concern is that so many women cannot get access to their electronic pregnancy records; this disempowers women and needs urgent attention.
“Maternity unit closures are also very worrying and will not solve the shortage of midwives in England. When a situation arises where a maternity unit has not enough staff and/or beds to care for women safely, the decision might be made to temporarily close the unit to new admissions and the RCM supports this.
However, such closures can last from a few hours to several days or more, with women who were booked to give birth in a particular unit then diverted to other units and this situation can be very unsettling for women. Also, if units are regularly and persistently having to close their doors it suggests there is an underlying problem around capacity and staffing levels that needs immediate attention.”
To contact the RCM Press Office call 020 7312 3456, or email pressofficer@rcm.org.uk.
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Notes to editors
For more information visit: www.maternityaudit.org.uk
More information will be added to the website as the audit progresses.
*A freestanding midwife-led unit is a maternity unit where midwives have primary responsibility for care during labour in women at low risk of complications and which is not located on the same site as an obstetric unit. If complications develop, women will be transferred to an obstetric unit by ambulance.
An alongside midwife-led unit is a maternity unit where midwives have primary responsibility for care during labour in women at low risk of complications and which is located on the same site as an obstetric unit so it has access to the same medical facilities if needed.
An obstetric unit is a maternity unit where care is provided by a team of midwives and doctors to women at low and at higher risk of complications. Midwives have primary responsibility for providing care in labour and afterwards to women at low risk of complications, while obstetricians have primary responsibility for women who are at increased risk of, or who develop complications. Obstetric, neonatal and medical services are available on site.
About the NMPA
The NMPA is a unique collaboration and audit that aims to produce high-quality information about NHS maternity and neonatal services which can be used by providers, commissioners and users of the services to benchmark against national standards and recommendations where these exist, and to identify good practice and areas for improvement in the care of women and babies.
The audit is commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of NHS England, the Welsh Government and the Health Department of the Scottish Government. It is being carried out by the Lindsay Stewart Centre for Audit and Clinical Informatics at the Royal College of Obstetrician and Gynaecologists (RCOG) in partnership with the Royal College of Midwives (RCM), the Royal College of Paediatrics and Child Health (RCPCH) and the London School of Hygiene and Tropical Medicine. For more information about the National Maternal and Perinatal Audit, visit: www.maternityaudit.org.uk
The RCM is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team. We provide workplace advice and support, professional and clinical guidance and information, and learning opportunities with our broad range of events, conferences and online resources. For more information visit the RCM website at https://www.rcm.org.uk/.