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Midwifery faces a mass 'exodus' warns RCM

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Midwives leaving the profession could risk care Midwives leaving the profession could risk maternity care for women

Excessive workloads and poor staffing levels have led many midwives to leave the profession according to research from the Royal College of Midwives (RCM).

The College surveyed over 2000 midwives who have left the profession in the last two years or are intending to leave the profession in the next two years.

Over half of the respondents (52%) said that the reason they had left down to diminished staffing levels and 48% said they were unhappy with the quality of care they are able to give due to this. Similar results were recorded by the midwives who were planning to leave with 62% saying they weren't happy with staffing levels and 52% said they were dissatisfied with the qualoty of care they were able to give. Some 46% said the excessive workload was one of the key reasons they were planning to leave.

'I worked as a community midwife specialising in low risk midwifery. Due to short staffing I was being sent in to cover high risk patients very regularly which I felt was unfair, unsafe and dangerous,' said one midwife from Wales who left the profession six-12 months ago.

Cathy Warwick, the chief executive of the RCM said that these results were 'saddening, dispiriting and worrying'. Ms Warwick highlighted that 'enormous demands' are being made on midwives, yet investment in these services from the government 'remains inadequate to provide the quality of care that women deserve'.

Only 9% of respondents felt that the government valued midwifery in comparison to 35% feeling that they were valued by their employer. 'I am fed up, trying to make changes to ensure good quality care, trying to discuss things with management. Last time I was told "If you can’t cope just leave". So I will,' said a midwife in Scotland, intending to leave midwifery in the next 18-24 months.

The survey also questioned midwives on what would encourage them to stay in the profession or return and the two main reasons were if the staffing levels improved or if the workload increased.

The RCM used these results to inform a set of recommendations to turn the situation around. These include:

  • NHS organisations should review their maternity staffing levels using a recognised workforce planning tool to ensure staffing reflects the workload.
  • NHS organisations should review their midwifery turnover and vacancies and address recruitment and retention issues. They should make use of recruitment and retention premia to counter existing shortages.
  • NHS organisations should sign up to the RCM’s Caring for You Charter (part of the RCM’s Caring for You Campaign) to take action on flexible working, breaks and workplace culture.
  • Government should end public sector pay restraint allowing the NHS Pay Review Body to make unfettered pay recommendations for NHS midwives and other staff, and break the 1% pay cap to ensure that midwives are fairly rewarded for the job they do.
  • The government should re-think its plans to abolish the bursary for midwifery students and not introduce tuition fees. Both of these actions will have consequences for the numbers of new students training to be midwives.

“I urge the government and employers to look at our recommendations . Let us all work together to keep the midwives we have and encourage those who have left to return,' added Ms Warwick.

This report follows the first Why Do Midwives Leave? document which was published in 2002. The follow-up report aims to document the changes that have ocurred in the midwifery profession since 2002.

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