Nine in 10 midwives say unsafe staffing levels are affecting the care they can provide to women and babies, and 3 in 4 have considered leaving the profession, according to a new Royal College of Midwives (RCM) survey.

The findings come as Donna Ockenden is due to publish her independent report on maternity care at Nottingham University Hospitals NHS Trust (NUH) this week — the largest maternity review in NHS history, involving nearly 2500 families and examining cases in which babies and mothers died or were injured.

The online survey of 3523 midwives, maternity support workers, and midwifery students took place between 8 and 18 June and covered the week of 1-7 June.

More than 3 in 4 midwives (77%) said their unit was not safely staffed during that week. Moreover, almost three quarters (72%) said staffing felt unsafe on more than half of their shifts over the past month. 

The survey also found that almost a third of respondents (30%) did not have 24 consecutive hours free from work, and 38% did not get the 11 hours of uninterrupted rest every 24 hours that working time regulations are meant to guarantee. 

Staffing Emergency 

In the last year, 3 in 4 midwives (75%) midwives had left or considered leaving the profession. Staffing levels were the reason given for 2 out of 3 (65%), with safety concerns cited for over half (54%). Other reasons were work-life balance (54%), and the impact on mental health (41%).

“Midwives are not leaving because they no longer care — they are leaving because the system will not let them provide the care they want to give,” said Robbie Turner, chief membership officer at the RCM, in a press release. “Three in four considering leaving is not a staffing problem, it is a staffing emergency,” he added.

Asked what factors would persuade them to stay or return, 66% said more midwives and maternity support workers, and 61% said increased pay. 

The survey also found that unpaid overtime was now routine, with 77% working extra unpaid hours in a single working week, and 1 in 5 working more than 5 hours beyond their contracted time for no additional pay.

Families at Risk From Poor Maternity Care 

“The hard truth is that the conditions that put women and babies at risk — exhausted staff, inadequate numbers, no time for breaks or training — are still the daily reality for midwives right now, across every part of the UK,” Turner said.

Ockenden is due to publish her report on maternity services at NUH on Wednesday. She is also leading separate inquiries into care at Leeds Teaching Hospitals NHS Trust and University Hospitals Sussex NHS Foundation Trust.

The final report from the National Maternity and Neonatal Investigation — led by Baroness Valerie Amos and examining 12 trusts — is also set to be published soon.

Rob Hicks is a retired National Health Service doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online publications. He is based in the United Kingdom.