Midwife shortages put babies at risk

Babies are regularly being put at risk by shortages of  midwives
in hospital maternity units, according to a new study.

The study of seven maternity units by Brenda Ashcroft and
colleagues, published in the British Medical Journal, found that
unreported “near misses” and were occurring in every
unit because of the shortfall of midwives.  In one case, an
emergency caesarean had to be delayed for two hours because there
was no midwife available to assist. The baby survived, but in poor
condition.

The study reports that, “no contingency plans existed in
any of the units to cope with the unexpected surges in demand for
care that occur frequently on labour wards. During intensely busy
periods, when shortfalls were most acute, senior midwives in charge
of the shift were unable to provide support for inexperienced
midwives.

“Latent failures therefore increased when combinations of
inexperienced midwife and inexperienced medical staff were left
unsupervised with complicated cases.”

High risk procedures such as epidural anaesthetics and
administering oxytocin to speed up labour were performed most
commonly in the units with the greatest midwifery shortages,
despite the fact that women need more support from midwives if they
have these procedures.

The study also found there were poor skill mixes among the
midwives available but because of midwife shortages, opportunities
for training and skills updating were not taken up.