Key points
- The government has committed to a ’national choice guarantee’ that by December 2009, depending on their circumstances, women and their partners will be able to choose whether they wish to give birth at home, in a midwifery unit or in an obstetric unit. The Department of Health estimates that about 2 per cent of women give birth at home. Recent research from the National Childbirth Trust claimed only 4 per cent of women are given a full range of choices.
- In 2007–8, 60 per cent of deliveries were conducted by midwives, according to the NHS Information Centre’s latest available figures, compared to 36 per cent by hospital doctors.
- Just under a quarter of deliveries in England were by caesarean section in 2007–8, of which around half were emergencies and the rest pre-planned, a notable rise from under 3 per cent in the 1950s and 12 per cent in 1990–91. The World Health Organization's target is for no more than 10-15 per cent of deliveries to be by caesarean section.
- In recent years, midwifery-led units have been established which provide women with the option to give birth with little or no medical intervention. Where these are situated on the same site as a consultant unit, they can quickly be transferred if there are complications.
- A maternity-specific workforce planning tool – Birthrate Plus – recommends a ratio of one midwife for every 29.5 women as the minimum standard necessary to achieve one-to-one care in established labour. The Royal College of Midwives (RCM) recommends using this indicator at national and/or regional level.
- The Nursing and Midwifery Council’s figures show there were 35,305 midwives registered to practise in the UK in 2008.
- According to the RCM’s evidence submission to the Pay Review Body in 2008, there was a shortage of approximately 5,000 whole time equivalent midwives in England alone.
- UK midwifery vacancy rates rose from 5.2 per cent in 2007 to 5.5 per cent in 2008. In 2008, the then health secretary Alan Johnson announced plans to provide former midwives with a £3,000 ‘golden handshake’ to encourage them to return to work after a break in service as part of a package of measures to recruit an extra 4,000 midwives to the NHS by 2012 – the equivalent of 3,400 full-time midwives. The announcement came shortly after the government allocated extra funding of £330m for trusts to invest in expanding their maternity workforce between 2008–2011.
- In May 2008 there were 1,676 consultants in post (number of NHS whole time equivalents = 1,574), 1,138 specialist registrars and 1,406 senior house officers according to The Royal College of Obstetricians and Gynaecologists’ annual census of the workforce. The College believes around 400 more consultants are needed for England and Wales alone.
