FactCheck: More midwives, but more babies
The claim
“It makes a huge difference to patients that there are now more midwives working in the NHS than ever before.”
Health Minister Simon Burn, Conservative Party press release, 21 February 2012
The analysis
The Conservative party boasted today that there are “more midwives working in the NHS than ever before”.
The official annual figures are published next month, but the Tories have used provisional figures to show that since the election the number of midwives has climbed by 4.4 per cent to 21,028 in England.
The government only started counting them in 1995, and by this measure there are more than ever recorded – in 1995 there were 18,034 full-time equivalent midwives (this tots up the hours worked; rather than doing a headcount of all workers – which includes part time midwives).
This amounts to 896 more midwives, however official figures show that the number of births in England are expected to climb from 687,007 this year to 723,000 by 2014-15.
Nevertheless, Health Minister Simon Burns has insisted the boost in the number of midwives will make a “huge difference” to patients.
Will they make a huge difference? We think this depends on how many midwives there are per child born.
And if you look at that ratio, in 1995 there were 34 newborn babies to every midwife. Fifteen years later in 2010, the ratio was 33 babies to every midwife. This is a small improvement.
However, if you look at it year-by-year, the number of babies per midwives was actually lower between 1999 and 2005 – hovering between 31 or 32 babies to each midwife. Since 2005, it has climbed back up.
Today’s small increase in the number of midwives is less than a third of the 3,000 David Cameron previously promised and well short of the 5,000 extra midwives that the Royal College of Midwives is currently campaigning for.
The Conservatives dropped the pledge from the Coalition Agreement on the basis that “predictions now suggest the birthrate will be stable over the next few years”. Yet as we show above, the ONS projects a rise in birth figures before the next parliament.
The verdict
The birth rate in England climbed steadily by 15 per cent between 2001 and 2010 – and official statistics predict a further 5 per cent rise over the next five years.
If the ONS’s prediction of the 2011 birth rate rings true, then this small injection of new midwives will have reduced the number of babies per midwife from 33 babies to one; to 32.8 babies to one.
Given that the last time that ratio was better was in 2005, FactCheck’s prognosis is that this small rise in the number of midwives will do little to offset the rising number of babies being born. To claim then that they will make a “huge difference to patients” seems over optimistic.
By Emma Thelwell
Follow @FactCheck on Twitter
Related story: Painful contractions – Cameron breaks his promise on midwives
There are 6 comments on this post
And the numbers are only half the story; the women midwives are caring for today are (on average) older, more likely to be obese and have more complicated medical and social requirements. In short they need more, and these ratios don’t enable midwives to provide that care.
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Cathy/Emma,
Here’s some things worth checking:
How many NHS reports in mainstream media are about defects in the service and how many are about excellence in the service? Why has media coverage of defective breast implants by private rip off companies been so sparse? Why is there no coverage at all of the effects of Yank style gangster “health care”? Why is there no coverage at all of drugs payments rip offs by drugs companies? Why is there no coverage at all of just how much private companies are now profiting on the backs of illness?
Just asking………
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Got to disagree with you on this one FC. It does make a difference as if the number of midwives had stayed the same, the service provided would obviously be less.
Yes the number of babies has increased and therefore the service provided may not have changed historically as the ratio of midwives to babies remains a constant but that is not a controllable variable.
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It might also be worth checking the midwife and babies numbers against those for multiple births as the ‘babies’ figures you’ve found might not equate to the number of mothers giving birth. However, this doesn’t mean less work (i.e. fewer women/births to attend to) – it probably means more. Women who give birth to twins (and more) are more likely to have pregnancy/birth complications and are therefore likely to require more intensive support from their midwifery team.
The number of multiple births has increased dramatically over the last 30 years or so and the cause is generally put down to the trend towards older first-time mothers (who are more likely to have twins anyway through simple biology) plus this age group is also more likely to seek/need fertility treatment. Fertility drugs themselves, unregulated overseas fertility treatment and, in recent years, greater use of and improved success rates for IVF have all contributed to the increase.
See HFEA regulations for the number of embryos transfered in IVF (IVF clinics now capped at 10% multiple birth rate), plus the oneatatime campaign website for more on this.
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As alluded to in the first post on this subject, there are other factors involved in providing good care in addition to the number of midwives.
For example, I work in a deprived area with the attendent health and social problems that this entails.
Also, English is not the first language of a portion of the community, and so direct communication with a woman can be very difficult and time consuming as well as possibly leading to misunderstandings.
Throughout the country, there are more operative deliveries now, the number of caesarian sections has risen by a significant amount which means more women are needing post-operative care and help with their babies. Women who have had c/sections will also need more vigilence in future labours.
All of these factors and more demand more time and input from midwives.
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I work in the community and although the number of appts per low risk woman has reduced due to introduction of NICE guidance, we now have more to do per appt and more information to give at appts that we have had to increase our appts to 15 minute slots minimum and more for taking blood, giving injections etc. There is far more detailed paperwork to complete to attain good grading from CNST and the CQC as well as attaining/maintaining Baby Friendly Status, to name but a few. These are for the benefit of the women that we look after to prove that we provide a safe and auditable service but take up a heck of a lot of time. There is more to do around Child Protection, as well as mums who misuse substances. Not only has our workload increased due to increased risk factors caused by obesity, age etc, but due to medical advances, we now have ladies who have babies who previously wouldn’t have fallen pregnant, transplant ladies for example, and babies born earlier. We have a statutory requirement to keep updated with mandatory study days etc which takes us away from the clinical area.
Yes Robin, the increase has meant that services can be maintained but they do not make a huge…
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