Scotland’s maternity services buckling under rising demand says RCM in new report
By RCM on 06 February 2017 Scotland Midwife Shortage Midwifery Workforce
A combination of high birthrates, an ageing workforce and an increase in births to older mothers means the pressure on Scotland’s maternity services is growing. This is highlighted in the Royal College of Midwives (RCM) Annual State of Maternity Services Report to be published today (22.00 Monday, 6th February 2017).
The RCM’s State of Maternity Services Report brings together information about maternity services in all four UK countries and also highlights the pressures on maternity services facing each country.
Despite a recent dip the report outlines that births remain high in Scotland. Grampian saw a rise in births of almost a quarter (23%) between 2003 and 2015. Across the same period a rise of almost 1,000 births was recorded in Lothian, a jump of over 11%.
Births are also becoming increasingly complex. A major Issue is the rise in obesity in pregnancy. These women can have more complications in pregnancy and often need additional support and care. In Scotland over a fifth of pregnant women (22%) are obese.
The increasing number of births to older women giving birth is a concern for Scotland’s maternity services. Births to women in their late thirties are up over 2,000 since the year 2000. Births to women aged 40 or older is up by around 1,000.
For women aged 45 or older, the number of births has jumped fourfold, from 29 to 143 between 2000 and 2015. These changes mean demands on maternity services are growing. All of these women deserve the right levels of advice and support in their pregnancy. Scotland is increasingly struggling to provide this.
Another pressing issue for Scotland is its ageing midwifery workforce, and the need to ensure that those heading for retirement are replaced. The report emphasises that the number of midwives and maternity care assistants in Scotland aged 50 or older rose, by 285. Staff aged 50 and over now constitute 41% of the workforce, the highest in the UK.
At the same time the number of younger midwives is falling. The number of midwives and maternity care assistants in Scotland aged under 50 fell by 217 between 2011 and 2016.
There is a growing age imbalance in Scotland’s maternity workforce. Real vigilance is needed to ensure Scotland plans ahead to ensure it is bringing through the right numbers of midwives. Recently announced increases in student midwife numbers go some way to offsetting this, but more is needed.
Remote and rural areas in Scotland are facing real pressures with some difficulties in recruiting midwives This pressing problems needs solving to ensure our rural services continue to serve their communities.
The RCM is working with the Scottish Government and the health service looking at intake planning for student midwives. The underlying message must be ensure that there are enough midwives with enough time to gather experience before the retirement time-bomb hits.
Mary Ross-Davie, Director for Scotland at the Royal College of Midwives, said: “Compared to England Scotland is doing well in terms of midwife numbers. However, we can do better and more are needed.
“We have to stop Scotland facing the shortage of midwives that has blighted England for over a decade. We will do this by ensuring that all those midwives heading for retirement are replaced in good time. This needs careful planning for the future, but it needs doing now.
“There are also significant challenges for our maternity services from rising levels of complexity in pregnancy and births. We have serious public health issues in Scotland with high levels of obesity and smoking in pregnancy among many other issues. With older mothers it is the women of course who will decide when they get pregnant, and we support whatever choices they make. What is important is that we have the right numbers of staff and resources to give all of these women the best possible care.
”Scotland’s maternity services are very good but there are signs that it is beginning to buckle as demand rises. Our Government and our NHS need to show even more that they value maternity services, that they value midwives and that they value the women, babies and their families that the service cares for.”
The full RCM State of Maternity Services Report 2016 can be found on the RCM website. The report will be live from 09.00 on Tuesday, 7th February 2017. Email the RCM press office for a copy of the report before this date.
To contact the RCM Press Office call 020 7312 3456 or email pressofficer@rcm.org.uk.
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Notes to editors
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/.
Statistics used in the report
Live births, Live births by NHS board area & Age profile of mothers (p9 & 10)
Annual birth figures for Scotland up to 2015 are available from National Records of Scotland: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/vital-events-reference-tables/2015/section-3-births
Figures for 2016 are available, also from National Records of Scotland: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/weekly-and-monthly-data-on-births-and-deaths/monthly-data-on-deaths-registered-in-scotland
Midwives, Age profile of midwives and MCAs, Student midwives & New student midwives (p10-12)
Quarterly workforce figures – covering this whole range of numbers – can be downloaded from ISD Scotland: http://www.isdscotland.org/Health-Topics/Workforce/Publications/data-tables.asp?id=1797#1797
Student numbers are listed as being from NHS Education for Scotland.
22% stat in sidebar (p10)
This is taken from the Births in Scottish Hospitals document, available from ISD Scotland at http://www.isdscotland.org/Health-Topics/Maternity-and-Births/Publications/2016-11-29/2016-11-29-Births-Report.pdf (see Maternal BMI section)