Surging birthrate means more midwives for Norfolk hospital

PUBLISHED: 06:26 17 September 2012 | UPDATED: 10:40 17 September 2012

12-week-old Rio Walker with mum Chelsea at the first birthday of the midwifery led birthing unit at the Norfolk and Norwich hospital.  Photo: Bill Smith

12-week-old Rio Walker with mum Chelsea at the first birthday of the midwifery led birthing unit at the Norfolk and Norwich hospital. Photo: Bill Smith

Archant © 2012

Surging birth rates have meant a shortage of midwives at the Norfolk and Norwich University Hospital.

But the hospital says it has now recruited extra midwives and is about to embark on a review of maternity services because the birth rate is predicted to increase further.

And parents have praised the midwifery-led birthing unit, which has just celebrated its first birthday and which hospital bosses say has helped relieve pressure on the delivery suite.

Last year there were 6,086 births at the Colney hospital, compared to 5,777 in 2008/9, and hospital bosses say they expect the birth rate to go up again by 4pc this year.

At times the hospital has not had enough midwives to provide one-to-one care on the delivery suite, and on six occasions since the start of the year the hospital has closed the delivery suite, with women sent to other hospitals.

Glynis Moore, head of midwifery at the N&N, said: “We have seen an increase in the birth rate in recent years and we estimate it will rise again this year by nearly four per cent. Our maternity service is expanding to keep pace with demand and we have increased the number of midwives on duty over the last nine months.

“During July, we also recruited a number of midwives to provide an extra 5.7 whole-time equivalents. Our normal recruitment pattern is to take a combination of students and experienced midwives and we take on about 23 staff each year during the spring and autumn. Across the country, hospitals are seeing a high demand for maternity care and to address the local picture we are carrying out a staffing review to look at the future needs of our service.

“We provide a high quality of care for local women and patient surveys show we perform well in terms of patient experience.”

The birth rate has increased nationally, but the reasons are not clear. Some research has suggested improved IVF treatment has contributed, while bosses at the N&N point to the 2011 census results which showed 60,000 more people are living in Norfolk now compared with 10 years ago.

On the decisions to close the delivery suite, a spokeswoman for the N&N, said: “There is a degree of unpredictability around the number of women in labour at any one time and this makes it difficult to plan with precision.

“It is important to provide safe care and, like every other unit in the country, there will be some occasions when it may be clinically safer to divert patients to other units. This is not ideal and it is not a decision we take lightly.”

Guidance from the Royal College of Obstetricians and Gynaecologists is for a minimum midwife to women ratio of 1:28 patients to allow one-to-one care throughout a pregnancy, although that varies based on the local population and individual specialisms of individual hospitals. The N&N’s ratio is 1:33.

A spokeswoman said: “In terms of the staffing ratio, there are many factors which will affect how the ratio of midwives to patients is calculated, such as the clinical case mix, turnover of staff, type of service offered and local birth rate.

“We periodically review our staffing ratio as the birth rate changes and our latest review will look at this ratio again taking into account all the elements of our service.”

The hospital last year created its midwifery-led birthing unit. Ms Moore said: “We have just reached the first anniversary of the unit which has delivered 1,187 babies during the last year and received very positive feedback from our patients and their partners.

“The new unit has also helped us to address the increase in births and offers women, who are healthy with a straightforward pregnancy, a home-from-home environment in which to have a natural birth.”

Extra midwives have also been taken on at other hospitals in the region, with the Royal College of Midwives this summer calling for the government to address the UK’s midwives shortage as the birth rate nationally goes up.

Carol Mutton, head of midwifery at the James Paget University Hospital in Gorleston, said: “Locally our birth rate is stable and we have seen no real increase in the the birth rate over the past eight years.

“Between 2008/09 and 2011/12 we increased the number of midwives by 10 wholetime equivalents and five of these were specialist midwives recruited to provide enhanced care for vulnerable women.

“This was a welcome investment designed to help meet our local needs. Our midwife to birth ratio is 1:26 and is better than the recommended ratio.”

The Queen Elizabeth Hospital in King’s Lynn said its ratios were within the guidelines, with more than 80 midwives.

Barbara James, head of midwifery, said: “Our locally trained students have wanted to stay after qualifying and we have been able to offer them positions here. The positive thing is that the midwives have wanted to stay with us. They receive excellent training, we have a good reputation and they generally like it here. We have also been able to recruit midwives from other areas.

“As far as midwives are concerned we can assure expectant mothers and their families that they will be treated here to a very high, safe standard.”

The West Suffolk Hospital, in Bury St Edmunds, said it had a ratio of 1:29 and that the number of babies born there had increased from 2,703 in 2010/11 to 2,823 in 2011/12.

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