Several stories in recent days illustrate the rather confused priorities of the British government towards maternal health.
Yesterday the Royal College of Midwives reported that parts of England are facing shortages of midwives of between ten and 41 per cent – set against the background of a 22% rise in birth rate over the last two decades. The RCM is concerned, quite rightly, that this puts the health and well being of mothers and babies at risk, with staff to stretched to do a good job and provide the level of care that they would wish to, or that mothers need. Interestingly, Scotland, Wales and Northern Ireland are not facing this gap. It is not a lack of trained midwives that is necessarily the problem (although training places are being cut, so we are storing up long term problems); at the moment this imbalance is purely down to the investment in midwifery services by different regions of the NHS in England.
David Cameron famously said that he was committed to improving midwifery services before the election, and in particular wanted to increase midwife numbers by 3,000. It seems that in England at least, the opposite seems to be happening, and the RCM are now campaigning for a further 5,000 midwifery posts.
At the same time, the WHO also reported that deaths in under fives were decreasing in the developing world, with twelve thousand fewer children dying each day globally than a decade ago. And today, the Lancet reports that in China, infant mortality rates have halved over the last decade due to an increased access to hospital based maternity services.
Reports from last year also show that there has been a marked improvement in the rates of maternal mortality in the developing world over the last two decades. We have not solved the problems, but we are making progress. Yet at the same time, here in the UK we are in real danger of stepping backwards. As the RCM points out, midwives are the backbone of our maternity services, and without them women are not getting the care they need to give birth safely.
It is right that we ring fence development funding and prioritise maternal and child health improvements in the developing world, because increasingly the evidence shows that this kind of aid and development is having a real impact on the lives and well being of the poor. But it cannot be right that at the same time we are cutting back on maternity services here in the UK and putting mothers at risk in this country. To be sure, the risks an English mother faces are not even remotely on the scale of those faced by a mother in, say, Afghanistan, but they are no less real and no less deserving of our full commitment and funding – two commodities that seems to be in short supply right now in Britain.