Cut-price midwives a 'risk' to babies

Ministers have reneged on an election promise to guarantee-that all mothers receive one-to-one care from a midwife during labour.

Health Secretary Patricia Hewitt - who promised to offer all women a home birth by 2009 - admitted that midwives would probably not be present during the whole labour in any NHS hospital.

Campaigners said that hard-up trusts could try to cut costs by replacing midwives with maternity support workers for much of the labour.

These staff, who earn around £12,000 a year, are meant to carry out simple tasks such as taking blood samples and cleaning up.

There is no national training programme and most trusts insist they take only a National Vocational Qualification, lasting 15 days over a year.

In contrast, midwives can earn up to £60,000 and must take an intensive three-year course, or 18 months if they are already qualified as a nurse.

Royal College of Midwives adviser Sue Jacob said it would be 'nothing short of scandalous' if support workers were left doing the job of midwives.

She said: "Women want nothing less than a midwife by their side when they are in labour. We know from all the research that's been done that continuous care from an experienced professional makes a huge difference to the safety of both the mother and the child."

Brenda Phipps of the National Childbirth Trust said: "Maternity support workers are cheaper than midwives and trusts are under financial pressure. It might be a temptation for a manager to cut costs by replacing a midwife with a maternity support worker.

"We really don't know what effect this will have and we just don't want to go there."

Beverley Beech of Action for Improvement in the Maternity Services said: "Replacing midwives with cheaper maternity support workers would increase the risk to mother and baby.

"It could cause developmental problems in babies if those looking after the mother do not recognise problems and do not take action."

A trainee midwife in a London hospital, who has done only six months of her three-year course, said some midwife support workers at her hospital had already helped in births.

She said: "It has happened. One of them told me she had assisted at a birth. I asked if she'd been on a course and she said no - she was just called in because they needed another pair of hands."

The trainee said she is regularly left alone to look after women because the midwives are rushed off their feet.

She said: "It is very dangerous - we have got the lives of mothers and babies in our hands.

'Lives could definitely be at risk because we don't know the signs of dangers in pregnancy. If you don't do anything about these signs then the mother and the baby could die."

The national maternity action plan, launched yesterday by Miss Hewitt, also promised to offer all expectant mothers a 'full range of birthing choices' by the end of 2009, including home birth, a midwife-led birth or a consultant-led birth.

This was dismissed by critics as hopelessly optimistic because of the NHS financial crisis. The Royal College of Midwives says there is a shortage of around 10,000 midwives.

The Health Department guidance, Maternity Matters, comes only a month after a survey found more than half of women had been left in a ward without a midwife or a doctor during labour.

The guidance says mothers should not be left alone. However, at times they will be under the charge of maternity support workers rather than a midwife.

Miss Hewitt said the department was not saying maternity support workers would be used as 'substitutes' for midwives during labour.

She said: "In certain areas, maternity support workers can be an important part of the maternity team and free up the team of midwives to concentrate on what only they can do.

"We see maternity support workers doing some of the clerical work, or home visits, taking blood tests, maybe helping to give a women a bath after giving birth.

"But maternity support workers cannot be a substitute for the care that only a qualified midwife can provide."

She added: "There will always be times when amidwife needs to be out of the room for a short time and the maternity support worker will be present there for that time. The midwife will not be there absolutely every moment of the time."