Around 37,000 women a year go to their GP or A&E services in the six weeks after giving birth because they are unable to see a midwife, according to a new report from the UK’s leading parenting group.
Lack of midwifery services is putting added pressure on overburdened GP surgeries and emergency services, as well as preventing mothers from receiving appropriate specialist care, the report said.
The report, Service Overdue,is based on a survey by parenting group the NCT and the Women’s Institute of 2,500 women who gave birth in England or Wales in 2014, 2015, and the first half of 2016.
NHS England said the number of midwives is increasing, and that it is ‘safer than ever’ to give birth in England.
Serious concerns
Women are ‘generally positive’ about their maternity care, the survey found. However, there is ‘serious cause for concern’ as policy goals continue to not be met.
Compared to findings from 2013, there has been ‘scant progress’ in measures meant to improve clinical outcomes, as well as instances where standards have declined by ‘considerable margins’, NCT said.
Unable to see a midwife
About one in five (18%) new mothers reported being unable to see a midwife as often as they needed in the six weeks after they gave birth, even though the majority of respondents (55%) were first time mothers.
NCT called the care ‘patchy’ and said that there has been no improvement in the last four years.
Almost a third (31%) of those women said this resulted in a delay in them or their baby’s health problem being diagnosed or treated.
Nearly three in 10 mothers (29%) said they were forced to seek help from their GP, a walk-in centre, or A&E as a result of the lack of midwife appointments.
Their main concerns were their baby not feeding properly, their own emotional or mental wellbeing, the healing of stitches or sutures and healing of caesarean scars.
‘Failing’ mothers and babies
The Royal College of Midwives (RCM) chief executive Cathy Warwick said that underfunding and under-resourcing postnatal care ‘not only puts pressure on other parts of the NHS, it also fails mothers and babies who may not be getting the care, support and advice they need’.
‘I am hearing increasing reports of babies requiring readmission to hospital because of lack of breastfeeding support,’ she added.
Warwick also criticised the mental health support for mothers, as early intervention is crucial to preventing very serious problems as well as separation of mother and baby.
‘Unfortunately, we remain 3,500 midwives short in England alone and with mounting pressures on hospital maternity units, we are seeing midwives been taken away from home visits due to chronic staffing shortages in units,’ she said.
‘Completely unacceptable’
Elizabeth Duff, Senior Policy Adviser, NCT, said: ‘It’s completely unacceptable that new mums have to get themselves to already fit-to-burst A&E departments.
‘The first weeks are challenging enough for parents without the added stress of waiting around for hours in casualty with their babies.
‘If the NHS provided better postnatal support, new parents would not be adding to the pressure on overburdened A&E departments and GP surgeries.
‘When we look at NHS budgets around 8% is allocated to postnatal care yet 80% of maternal deaths happen at this time. We do feel there is a mis-match.’
Workforce recruitment
The NCT report called for the implementation of the Better Births plan and NICE’s guidance that women should see a midwife as often as they require postnatally, and said that local commissioners should agree on the acceptable average number of postnatal visits appropriate to each population.
It called for the Government to scrap its plans to remove bursaries for student midwives in England and to improve recruitment to lessen ‘the 3,500 gap’ in England’s midwifery workforce.
‘Safe to give birth’
NHS England said that the number of midwives has been steadily increasing over the last five years and is expected to continue as more are trained.
‘It is safer than ever to give birth in this country and the vast majority of mothers report they received great NHS care.
‘We are now working to implement the recommendations made by Better Births across the NHS, including providing better postnatal care and access to a small team of midwives for continuity throughout the pregnancy, birth and postnatally ensuring all women receive the best possible care.’
Provision planning
The RCM’s director for midwifery Louise Silverton said: ‘The lack of consideration of maternity services is highlighted in the NHS Sustainability and Transformation Plans (STPs). As RCM analysis recently found, many of the STPs make only passing mention of maternity services, if they are mentioned at all. This is not good enough.
‘Serious and sustained investment in maternity care is needed to counter the huge increase in births over the last decade or more, the increasing demands on the service and the historical lack of funding.’
