With her first baby due in a few weeks, Gemma Ricketts had made careful plans for a home birth, helped by a midwife she had come to know and trust during her #pregnancy. A private maternity service called Neighbourhood Midwives, funded by the #NHS, had offered her and many others exactly the kind of attention that was last month trumpeted by Matt Hancock, the health secretary, as he set out plans to make Britain “the best place in the world to give birth” – personalised, continuous care by a named midwife and greater choice for the expectant mother when planning her delivery.
So when she received an email out of the blue telling her that Neighbourhood Midwives, which operated in Walthamstow, north-east London, was closing down with eight days’ notice, Ricketts was shocked and distressed. The 33-year-old is one of scores of heavily pregnant women who have been left in the lurch. Many have been advised to sort out alternative care themselves, and little information has been offered about why the scheme has ended so abruptly. Nine midwives have lost their jobs.
“It was so sudden, there was almost no notice,” Ricketts told the Observer. “I feel I’ve gone from a gold standard of care to the bare legal minimum. We’ve been left on our own when we’re at our most vulnerable.”
Neighbourhood Midwives was a pilot project providing a high standard of antenatal, delivery and postnatal care that had NHS funding until November this year. Its closure on 31 January came less than a month after the government, as part of its 10-year plan for the NHS, outlined ambitious new maternity care plans that stressed a need for greater “continuity of care” so that women could be assigned a named midwife throughout their pregnancy who would stay with them during the birth and as they settled at home with their baby. Currently, women see several, if not more than a dozen, different midwives before, during and after birth. And the disappearance of a service like the one in Walthamstow has emphasised how far the UK has to go before it comes close to realising the government’s targets.
“Of course, we’d love to be the best place in the world to give birth,” said Helen Shallow, a leading midwife. “But that’s just fantasy land at the moment. For every step forward we take, we seem to take three steps back. It’s incredibly frustrating.” Midwifery-led care, such as that offered by Neighbourhood Midwives, has been shown to improve outcomes for pregnant women but was under-resourced, she said.
Despite the government’s ambitions, the UK remains short of 3,500 midwives – and the number of midwives coming to work in the UK from Europe has collapsed since the EU referendum. In the 12 months to March 2018, just 33 European midwives registered to work in the UK, compared with over 250 pre-referendum. In the same 12 months, 234 European midwives left the country.