NICE recommends that there should be one midwife during birth in its second guideline for safe staffing in the NHS.
The new recommendations set out responsibilities for senior managers and organisations as part of their midwifery staff planning. It also sets out how registered midwives on a shift should monitor whether there are sufficient staff to provide safe care for the needs of women and babies.
The guideline provides step-by-step guidance for organisations to work out the number of midwives required including making sure that local records are used to help predict requirements and any potential variations in demand.
For senior midwives, the guideline recommends regularly monitoring positive and negative events, which can inform on whether staffing is adequate. This can be done using data already being routinely collected, such as appointments being booked on time, mothers given help with breastfeeding or staff-reported events like missed breaks and overtime.
The guidance also highlights warning signs for patients and hospital staff to identify when there may be too few midwives.
Cathy Warwick, chief executive officer at the RCM, said: 'I welcome this guidance, which should help to ensure that maternity services have safe staffing levels that are monitored on a regular basis and are adjusted according to local need. The report highlights the vital importance of ensuring adequate staffing in the antenatal and postnatal periods, as well as in labour.
'I am very glad that the guidance focuses primarily on the needs of women and babies, and the importance of making time to give them individualised care; this will help ensure women and babies get the care they deserve.'
This guideline was commissioned by the DH and NHS England in November 2013, and is part of a series of guidelines that NICE will develop on safe staffing in the NHS, with a focus on nursing and midwifery. Guidelines for community nursing will be released in March 2015.