Pressure to start Valuing Maternity
The impact of the recession and austerity policies on pregnant women and new mothers has received little attention to date. With the focus on overall job losses and cuts to direct services, the cumulative impacts on this low profile group has escaped the notice of politicians and policy makers.
This is changing. A coalition of unions, women’s groups, parenting organisations and advice services have come together to call for a halt to the cuts and the policies which are making women’s lives increasingly difficult. Led by Maternity Action, the Valuing Maternity campaign is calling for job security for pregnant women and new mothers, parental leave which promotes real equality, and services to support a safe and healthy pregnancy.
On NHS maternity services, we’re highlighting the harsh contraction of maternity services on the ground and the removal of important mechanisms to monitor and address impacts on maternity care.
Concerns about cuts to maternity services at local level have been articulated in regional media and online forums in recent months. With the release of the Care Quality Commission’s first ‘market report’ on health services, the national picture has become much clearer. Nearly one in seven trusts providing maternity services do not meet the recommended midwifery ration of one midwife for every 28 births. This means that nearly one in seven trusts is struggling to staff its services to a level which ensures a safe birth and provides mothers with a positive birth experience.
The CQC report pointed to the growing pressures on maternity services. The birth rate rose by 21% in the last decade, and midwifery numbers rose by only 15%. At the same time, the complexity of births has also increased. Between 1990 and 2010, the number of births to women over 40 has trebled.
The Royal College of Midwives has called for an additional 5000 midwives to deal with the growing need. To date, their e-petition has attracted over 58 000 supporters and they are well on the way to achieving the numbers required to ensure that the issue is debated in Parliament. A recent motion on midwifery at the Women’s Institute national conference reflects the broad based and growing concern about this issue.
In May 2012, the Government announced that every woman will have one-to-one midwifery care during labour and birth. This is a very welcome commitment, but requires an implementation strategy. Under the NHS reforms, the old national policies, services agreements and targets, regional performance management and local commissioning are being replaced by local level decision making. There are no national service standards against which services can be evaluated. There is no national monitoring of compliance with the new announcement. At best, the announcement can be seen as a statement of aspiration. At worst, it is pure window dressing for the £20 billion of ‘efficiency savings’ which are currently being dragged out of the NHS.
The Valuing Maternity campaign has some basic demands for maternity services:
- Midwifery numbers must increase to reflect growth in demand.
- Put in place a national strategy for women who need greater support.
- Establish robust mechanisms at local level to ensure Government commitments are monitored and delivered.
- And move swiftly to re-establish the review of maternal deaths which provides essential data to improve maternal health outcomes.