Friday, January 11, 2008

Shocking NHS figures show mothers and babies are at risk due to chronic shortage of midwives

Mothers and babies are being put at risk in NHS hospitals because midwives are so overstretched, shocking new figures show. Midwives are being forced to oversee more births than they were six years ago, meaning they can not give women the support they need to ensure they stay safe.

In some parts of the country midwives are in charge of 25 per cent more births as they were in 2001, according to the official figures obtained by the Liberal Democrats. The average midwife is now overseeing 33 births a year - well in excess of the guidelines which state they should deal with no more than 28 births. The desperate shortage means thousands of women are giving birth terrified and alone in NHS maternity units, while many are being forced to have children in filthy wards.

Over Christmas two women died at the same hospital from the same infection - raising fresh concerns about hygiene standards in the NHS. The Royal College of Midwives said last night that the figures proved that NHS maternity services were "crumbling", with many units are under threat.

Liberal Democrat health spokesman Norman Lamb said: "These figures show that our maternity services are under huge strain around the country. "There simply aren't enough midwives to deliver on the Government's promises of one-to-one maternity care. "With the birth rate rising and many midwives set to retire over the next decade, the situation is set to get worse. "A chronic shortage of midwives could also force the closure of small childbirth centres across the country. "The Government needs to stop burying its head in the sand and launch a national review of capacity in maternity services."

Official guidelines, published in 2006 by the Royal College of Obstetricians and Gynaecologists, say that midwives should oversee no more than 28 births a year. The figures, revealed following a parliamentary question, show that across England in 2001, the average midwife oversaw 31 births. By 2006 that had risen to 33 - a rise of seven per cent. ....

Experts say fewer midwives per birth leads to increasing risks for mothers and babies. Belinda Phipps of the National Childbirth Trust said: "As the number of birth per midwives rise, the risk of a woman being in labour without a midwife by her side rises. "This is not just a 'nice to have' but is clinically important and makes a difference to a woman's labour and birth. "You would not expect to go into hospital for an operation and have the hospital tell you your anaesthetist will be running between three patients in different operating theatres. "It is not acceptable for women in labour to be expected to have their midwife running between several women also in labour.

"At the moment the only way you can be sure to have a midwife with you throughout your labour is to have your baby at home. "Women who choose to give birth in hospital also need to be assured they will have a midwife with them throughout their labour. "Using a hospital's emergency facilities to rescue women who have not had the full attention of a midwife is not acceptable practice."

Louise Silverton, deputy general secretary of the Royal College of Midwives, said: "While we support the Government's plans for maternity services, we have real concerns about their ability to deliver because there are simply not enough midwives. We need 5,000 more full-time midwives by 2009. "The birth rate is rising, midwife numbers are dropping, but the maternity services budget is falling and the maternity service is crumbling. "Ultimately it will be women and their babies who suffer a poor maternity service, and midwives will be left underresourced and overstretched. "Women report to us that because the midwives are so busy, they do not ask questions for extra support. "Women are being short changed by the shortage of midwives."

The increasing ratios have occurred because the Government has not employed increasing numbers of staff to keep pace with rising birth rates. Since 2001 the birthrate has shot up by 12.5 per cent, from 564,871 babies born to 635,679 in 2006 - a bigger rise than Government actuaries had expected. Midwife numbers have increased by just 5 per cent since Labour came to power in 1997, from 18,053 to 18,862 in 2006 - with 2006 seeing a drop in numbers on the previous year.

Fewer new midwives are being trained every year - down 16 per cent in the last two years; and newly-qualified midwives are struggling to find jobs because many trusts still have financial problems. And the RCM warns the problem could get worse, with half of midwives planning to retire within the next decade.

The amount being spent on maternity services has fallen from 1.7 billion in 2005/06 to 1.6 billion pounds last year. The shortage of midwives will make it all the more difficult for the Government to meet its pledge that by the end of 2009, all women will be supported by one named midwife throughout her pregnancy and afterwards. The Conservatives claim that more than 30 maternity units across the country are under threat of closure.

A spokesman for the Department of Health said: "England remains one of the safest places to have a baby either in hospital or at home. "The number of midwives is increasing. Between 1997 and 2006, the (headcount) number of midwives employed in the NHS has increased by 2,084 (9 per cent), which represents a whole time equivalent (WTE) increase of 809 (5 per cent). "There has also been a 20 per cent increase in the number of students entering training to become a midwife. "Through increased investment in training staff and finding ways for midwives to come back to work in the NHS, we expect to see further increases in the midwifery workforce. But we are not stopping there. "In some parts of the country, we must and will do more, like developing more training places, bringing in flexible working and finding innovative ways to fill hard to fill vacancies."


NHS negligence kills young mother

A woman died while giving birth after a clerical error left her without specialist medical care, despite both her mother and her aunt having been killed by the same rare condition at exactly the same age, an inquest was told yesterday.

Kelly Hutchings, 22, of Fareham, Hampshire, suffered a brain haemorrhage during the birth of her daughter, Nikita, on November 16, 2005. When Ms Hutchings became pregnant for the first time that spring, no appointment was made for her to see a consultant obstetrician despite her family's "significant medical history" and referrals by her doctor and a midwife. Her need for specialist care was then overlooked by midwives and doctors on up to six further occasions, the inquest in Southampton was told.

Keith Wiseman, the coroner, said that it was "incredible" that a case like hers had slipped through the net, describing it as "like going through six or seven red lights and not realising".

The inquest was told that Ms Hutchings's mother, Shirley, had died at the age of 22 while giving birth to Kelly's brother, Mark, who is now 20. Her aunt, Sue Hickmott, had died in 1982, at the same age and from the same condition, known as deep cerebral venous thrombosis, which causes brain haemorrhage during childbirth.

However, an administrative error by Portsmouth Hospitals NHS Trust meant that an appointment for Ms Hutchings to see Marwan Salloum, a consultant obstetrician, never happened. She was seen finally by a specialist was when she fell seriously ill towards the end of her pregnancy. She was admitted to Southampton General Hospital complaining of dizziness and headaches, but her condition deteriorated and, just over 30 weeks into her pregnancy, she went into labour.

Ms Hutchings, who also suffered from cerebral palsy, was kept alive on a life-support machine while Nikita was delivered by Caesarean section. Her daughter, who has severe disabilities including blindness, cerebral palsy and brain damage, is being raised by her partner, Lee Blyth.

Donna Ockenden, head midwife for Portsmouth Hospitals NHS Trust, explained that Dr Peter Smith, Ms Hutchings's GP, had first made a referral for an appointment with a consultant. But this was "overridden" and downgraded to a midwife appointment because he had not provided any reason for the request.

A request with details of the family history, was made by June Brown, Ms Hutchings's midwife. It was approved by Mr Salloum, but Mrs Ockenden said that a "clerical error" meant the appointment was not made because the interview with the midwife was already in place. She added: "Although the history was clearly visible on the front of Kelly's notes, it was not picked up that it was a high-risk issue." Mrs Ockenden said that procedures at the trust had since been changed.

Mr Salloum told the inquest that he considered Ms Hutchings a high-risk case. "The referral that came to my attention had a box that said Kelly was anxious that her mother and her aunt both died in childbirth from a brain haemorrhage. I would like to at least discuss that with the patient."

Dr Smith said that Ms Hutchings had made no reference to her family history when she came to see him. Her stepmother, Merissa Hutchings, 41, said that she was not a "forceful girl" who would have raised concerns on her own behalf.


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