The Quality Of Maternity Care, Staffing Levels And Pay Top Table Of Midwives' Worries, UK

Main Category: Nursing / Midwifery
Article Date: 13 Aug 2008 - 4:00 PDT

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The quality of maternity care, overstretched staffing levels and low pay are the issues that most concern midwives, reveals a survey published by the Royal College of Midwives (RCM). The survey of midwives across the UK also showed that most midwives felt that working today as a midwife is more challenging than it was five years ago.

Midwives responding to the survey say that the baby boom is having an impact on their work. Thirty-one percent say their workload has increased, which means they have less time to spend with the women in their care. Consequently, this affects the quality of care women are receiving with 38% of midwives saying that the quality of care has been negatively impacted by the baby boom. Almost two-thirds (61%) of respondents said that these issues are adversely impacting their job satisfaction.

Dame Karlene Davis, general secretary of the Royal College of Midwives, said:

"Maternity services for all women could, and should, be so much better. We acknowledge that most women are happy with the service they get, but too many are unsatisfied and frustrated.

"Midwives' pay is not keeping pace with prices, staff numbers are not keeping pace with the birthrate, and investment is not keeping pace with the demands on the service."

"We are going to see a haemorrhage in the profession if the conditions midwives work in are not addressed. Give midwives the tools and resources to do their job and they will deliver a service of which this country can be proud."

Nearly all (91%) of midwives said that their maternity unit had seen a birthrate increase in the previous year. Despite a slight (2.5%) increase in the past year*, midwife numbers are still failing to keep pace with the birthrate which have increased by 3.5% in the same period**.

Along with staffing levels, pay is cited as one of the midwives' key concern. Over two-thirds (39%) of respondents said that they want the RCM to focus on this over the next three years. The Government recently ignored the advice of the Independent NHS Pay Review Board and imposed a three-year, below inflation, pay award on midwives.

There remains a "retirement time-bomb" in the midwifery profession, with nearly half of all midwives (46%) set to retire within ten years, which is a real concern in the current climate of climbing birthrates. The RCM estimates that at least five-thousand more midwives are needed to make the Government's maternity plans achievable.

The time pressures on midwives are reflected in their responses to questions on breaks at work. Over a third (38%) of respondents said they rarely took a break at work and nearly half (48%) said they only got a break sometimes. Just 8% said they always got a break.

The increasing demands on midwives' time are also reflected in their working hours. Three-quarters (74%) said they worked up to ten extra hours a week, with 14% working 11-20 extra hours per week. Two-fifths (41%) of those who worked extra hours received no compensation in either time-off or extra pay, whilst almost the same number (39%) received time-off as compensation for the extra hours. A fifth received time-off, overtime or a combination of both.

The survey shows a mixed picture on Continuing Professional Development (CPD); nearly half (45%) say it is about the same as last year, with over a quarter (28%) saying that it was somewhat or much better. Worryingly, a similar number (27%) say opportunities for development are somewhat worse or much worse.

Encouragingly, most respondents (96%) said they had not been physically abused whilst at work in the past year. However, over half (55%) said they had been verbally abused.

Notes

1. The Royal College of Midwives (RCM) aims to promote and advance the profession of the midwife. The RCM represents 37,000 members, over 95% of the UK's midwives, and is one of the world's oldest and one of the largest midwifery organisations, and celebrated its 125th anniversary in 2006. It is also a trade union. For more information visit the RCM website at http://www.rcm.org.uk.

2. 2,489 midwives responded to the survey which was conducted in April 2008

3. In 2007, in England, there were over 90,000 more live births than in 2001, a rise of over 16%, but the number of midwives is not keeping pace with the increasing birth rate.

* In 2006 there were 18,862 Whole Time Equivalent midwives in the NHS in England. In 2007 (the latest figures available) there were 19,298 (Source, Department of Health non-medical workforce census in 2006 and 2007)

**Birthrate figures from Office for National Statistics live birth figures for England, July 2007

Royal College of Midwives

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