Notes to editors
For further information, or to request an interview, please contact the press and public affairs office at The King's Fund on 020 7307 2585 (if you are calling out of hours, please ring 07584 146035).
The report, Staffing in maternity units: getting the right people in the right place at the right time, was informed by work commissioned by The King's Fund from academics in England, Australia and Canada led by Professor Jane Sandall at King's College London. It considered safety in labour and birth for women and babies via a literature review and interviews with key UK stakeholders about the improvement of practice through workforce changes. To read the report, please visit The King's Fund website.
Most women and babies do better under midwife-led care around labour and birth when compared with doctor-led care or models where different professionals share responsibility for their care. In 2009-10, 10.1% of hospital births in England took place in midwife-led settings, with the remainder of births in doctor-led care or shared care units, according to NHS Maternity Statistics, 2009-10. (see Table 1: Place of delivery, 1989-90 to 2009-10)
Midwife-led care is associated with several significant benefits for mothers and babies, and not with adverse effects. Women receiving midwife-led care in hospital are less likely to be hospitalised after the birth, and are less likely to have episiotomy and an instrumentalised birth. Among the benefits of midwife-led care, they are also more likely to have a spontaneous vaginal birth, to feel in control during the birth and to initiate breastfeeding.
Writing in The Sun newspaper in January 2010, David Cameron said midwives were 'stretched to breaking point', 'overworked and demoralised', and pledged that he would 'increase the number of midwives by 3000'. RCM is campaigning on the fulfilment of this pledge and have spoken of the need for '4,700 more midwives in England to provide a safe and high quality service for women'.
The report found that ensuring quality and safety in wards is not solely dependent on the absolute numbers of staff, but is also associated with the skill mix and the deployment of staff. The same, or better, outcomes for women were linked to an extended midwife role. The potential benefits of the appropriate use of maternity support workers and neonatal nurses in freeing up midwives' time were also highlighted in the findings.
While the overwhelming majority of births in England have been shown to be safe, evidence shows that a systematic approach to ensuring safety across maternity services is lacking, which can create unnecessary risks. From September 2009, the Safer Births service improvement programme run by The King's Fund with national and local partners has worked to improve the safety of maternity services by supporting frontline professionals and sharing good practice.
The King's Fund is a charity that seeks to understand how the health system in England can be improved. Using that insight, we help shape policy, transform services and bring about behaviour change. Our work includes research, analysis, leadership development and service improvement. We also offer a wide range of resources to help everyone working in health to share knowledge, learning and ideas.