A survey of midwives has called into question the future ability of Scotland to deliver maternity services, with  seven in ten thinking of quitting because of poor staffing levels – with many reporting that they rarely have enough staff on duty to provide safe care.

The professional organisation for midwifery, the Royal College of Midwives (RCM), says a survey of frontline staff has painted a “deeply worrying picture of staff that are on their knees and are not currently seeing a way forward”.

RCM, which also acts as a trade union for midwifery, says responses to a survey of members show seven out of ten midwives are thinking of leaving due to high stress, low staffing levels and frustration with the quality of care they can provide.

Staffing levels were reported to be consistently ‘unsafe’, with concerns about the quality of care being cited by more than half of those who say they are considering leaving.

Just under 90% of the 871 respondents said they were under significant levels of work-related stress.

One midwife said: “I have nothing left to give my own children and family at the end of the day. I am at breaking point.”

Others say they routinely miss breaks – some reporting not getting the chance to have a drink or take toilet breaks. One said::

“When I say no break, I mean flooding through sanitary products onto my clothing because I cannot take 10 minutes to change my tampon in a 12 hour shift.”

RCM says workforce concerns are being further exacerbated by many  more experienced midwives, and those at the end of their careers, who postponed retirement because of the pandemic and , are now beginning to exit.

RCM Director for Scotland, Jaki Lambert, is calling for more support for midwifery teams:

“I know midwives and maternity support workers provide excellent care daily to families, but we cannot rely on goodwill alone.

“This shows deep-seated and long-standing issues, certainly worsened by the pandemic which midwives fear are already impacting on the quality of care for women and their babies.

“There is a worrying catalogue of issues and discontent with an exhausted and a fragile maternity workforce with rock bottom morale.

“They have also been emotionally and physically battered by the pandemic and left feeling that their work and efforts are not valued.

“We need to move forward together with the government from this point.”

The RCM is calling for more support for midwives early in their career to ensure they can remain positive about their career choice. The organisation wants to see protected time to ensure midwives can undertake essential education and development training, alongside a ‘proportionate and substantial’ increase in the number of people promoted to consultant midwife and clinical educator posts to support the profession in ensuring safe care.

RCM says the introduction of an accurate tool to determine midwifery staffing levels is also overdue.

Ms Lambert added:

“We can and must do better for midwives, women, babies and families in Scotland.

“We know that the Scottish government wants to fix this, I want to work with them to make sure the midwives are valued, and their expertise recognised.”

Responding to the RCM findings, Scotland's Women’s Health Minister Maree Todd said:

“I want to thank all of our midwives for the incredible work that they have done, and continue to do, during the pandemic. I recognise the pressures in the system and we are committed to listening and working with all partners to find solutions. I am also grateful for RCM Scotland for this work on the first National Survey Report and the chance to discuss their findings.

“It is critical staff wellbeing is looked after and they are able to take the rest breaks and leave to which they are entitled, as well as being given time to access national and local wellbeing resources at work. That is why we made £12 million available in 2021-22 to support the mental health and wellbeing of the workforce.

“NHS Scotland staffing is at a record high level following ten consecutive years of growth, with overall staffing up by over 22% since 2006 and our national strategy commits to increasing the NHS workforce even further, with 1,800 additional full time posts on top of projected workforce growth requirements. There has been an increase in the number of student Midwifery places this year and the shortened midwifery course for existing staff is now opening for its second year, which will help deliver safe, effective quality care for women and their families, as well as developing our existing workforce.

“This report highlights important issues and we will fully consider all of the recommendations, and how these interact with work already underway. A sustainable, skilled and supported workforce is absolutely vital to deliver the care patients need and this report will help us build on the commitments we’ve made in the Programme for Government, NHS Recovery Plan and National Workforce Strategy for Health and Social Care to maintain and improve services across the country.”

 

Read more: “More questions than answers” in workforce plan; Maternity services face “chronic” staffing gaps; Universities not equipped for student midwife rise

 

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