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Underfunded and overworked: Midwives reveal extent of NHS maternity crisis

For every 30 midwives who train in the UK, 29 leave the profession. We spoke with five midwives to learn more about why they think their line of work is facing a staffing shortage.

It’s a role that involves supporting families at their most vulnerable, working long hours around the clock, and bringing new life into the world. A typical shift is demanding and plays a critical part in a life-changing moment, but midwives in the UK are facing a staffing crisis

Statistics reported by the National Health Executive reveal that for every 30 midwives who train, 29 leave the profession, making the position severely understaffed in the UK.

Throughout November, hundreds of midwives and supportive members of the public joined March with Midwives vigils in around 50 towns and cities across the UK. They intended to draw attention to issues faced by midwives, including cuts to funding and staffing, and raise awareness about the current maternity crisis. 

The Big Issue caught up with five midwives to ask why they think their profession is facing a staffing shortage, and learn more about some of the favourite parts of their job.

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Image: Cara McCarthy

Name: Cara McCarthy

Age: 42

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From: Essex 

Midwife for: Five years

Why do you think midwives are facing a staffing shortage in the UK?

Many reasons, the most being the working conditions. We are constantly promised a pay rise, and you get the, ‘Well, you were given a 3 per cent pay rise last year’, which is true, but that’s after years of not getting any pay rise at all. Midwives also have to pay an annual fee of £120 every year just to keep our registration up. Inflation has just been reported to be 4 per cent , so already, we’re in a pay cut again.

On top of that, you’ve got the workload. I work in one of the busiest maternity units in the country. Sometimes you don’t get to have a toilet break, you don’t get to eat, you don’t get to have a drink, you’re standing on your feet for 12-and-a-half hours. In amongst all of that, you’ve got to be physically present in the moment, your brain has to be switched on every single minute of that shift. It’s mentally and physically exhausting. 

What is the best part about your job?

For me, I like the building up of the relationship. It’s always been my favourite part. In this environment, people bring all of their fears, their worries, their hopes and their excitement. In that moment, that little pocket of 30 minutes, you get to build up such a special way of communicating. It’s our role to empower them, so that they go off and believe in themselves that they can go and have this baby.

Image: Leah Hazzard

Name: Leah Hazard, author of the memoir Hard Pushed: A Midwife’s Story

Age: 44

From: Scotland

Midwife for: Eight years 

Why do you think midwives are facing a staffing shortage in the UK?

The midwifery shortage has been caused by years of underfunding. Historically, the government has failed to appreciate the importance of pregnancy and birth as fundamental experiences, and the role of midwives in laying the foundations of public health. We are now seeing the consequences of this short-sighted view.

What is the best part about your job?

The best part of my job is knowing that I am helping to protect and empower women and other birthing people during one of the most important events in their life. 

Image: Laura Godgrey-Isaacs

Name: Laura Godfrey-Isaacs

From: London

Midwife for: Five years

Why do you think midwives are facing a staffing shortage in the UK?

There has been a shortage of midwives for many years, that predates the pandemic. Historically, we have not been training and recruiting enough midwives, but we have also had an issue with retention.

The pandemic means that the pressures have increased to an intolerable level, leading to many more midwives leaving or being off sick with exhaustion or illness. The additional pressures due to the pandemic, such as new procedures and disruption to services, wearing PPE, fears and concerns about the virus. and sickness/self-isolation has intensified midwives’ workload and stress.

Additionally, the medical system in which most of midwifery is operating in can often feel at odds with the principles of midwifery – the lack of funding for the NHS and workload issues, alongside the medicalisation of childbirth, means that midwives find it difficult to deliver the care that underlies our profession. Being ‘with woman’, giving the time, attention and support for the processes of birth are often in stark contrast to the structures we work in, where birthing people are pushed through the system that caters for them as if they were sick patients, rather than birthing, which is a normal physiological process. These tensions lead to many midwives feeling they cannot operate in an industrialised system of healthcare that does not recognise the unique circumstance of birth.

What is the best part about your job?

The best part of my job is spending time supporting women and families transition to parenthoodseeing them become a family, and feeling that I have contributed positively to their future growth and development. 

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Image: Paul Golden

Name: Paul Golden

From: New Zealand, havingworked as a midwife in the UK, EU, New Zealand, Australia and Asia.

Midwife for: Thirty years

Why do you think midwives are facing a staffing shortage in the UK?

The main reason why midwives are facing a shortage is due to the bullying culture and hierarchal system based on fear within the profession. This is something which can make working difficult and contributes to feeling burnt out. Fear of the employer and of the regulator are affecting the care that midwives can and cannot give.

What is the best part about your job?

Being a midwife and being with women, their babies and families is all about love. It’s very satisfying being able to witness and participate in life with love.

Image: Bridie Black

Name: Bridie Black

Age: 35

From: London

Midwife for: Thirteen years

Why do you think midwives are facing a staffing shortage in the UK?

I think maternity is often run on the goodwill of midwives. When you become a midwife, you’re not in it for the money, or the glamour or anything like that, you’re in it because you want to do it. If you’re with a lady who is in labour and there’s nobody to take over from you, you often have to work overtime. I think that goodwill can burn some midwives out, because they really go above and beyond. 

Midwifery is also such an unpredictable profession. You don’t know who is going to walk through the door and you never really know what’s going to happen. You might have one night that is really quiet and one night that’s really busy. It really is a frontline service, like an A&E department.

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What is the best part about your job?

I know it sounds a bit cheesy but being with the women I care for. In July, I left the NHS to move to Cyprus and I’ve got a job as a midwife here. When I reflect on what I miss, I used to work on a vulnerable women’s team in the UK with about 20 women on my caseload. Being able to offer them support was something I loved.

That feeling of ‘I’ve done something worthy today’ and someone’s appreciated what I’ve done, that’s really nice. It’s very rewarding.

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