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Women to get childbirth choices Women to get childbirth choices
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Women in England are to be given a choice of where they give birth, under plans due to be unveiled by ministers.Women in England are to be given a choice of where they give birth, under plans due to be unveiled by ministers.
From 2009, expectant mothers will be able to choose whether they go to hospital, a midwife-led unit or stay at home to have their children delivered.From 2009, expectant mothers will be able to choose whether they go to hospital, a midwife-led unit or stay at home to have their children delivered.
Women will also be guaranteed a named midwife to care for them throughout their pregnancy.Women will also be guaranteed a named midwife to care for them throughout their pregnancy.
Midwives said more cash is needed to fulfil the promises, which were first outlined in Labour's manifesto in 2005.Midwives said more cash is needed to fulfil the promises, which were first outlined in Labour's manifesto in 2005.
The government has acknowledged that the plan can only be delivered with more midwives Dame Karlene DavisRoyal College of Midwives spokesman 'I had to pay for home birth'The government has acknowledged that the plan can only be delivered with more midwives Dame Karlene DavisRoyal College of Midwives spokesman 'I had to pay for home birth'
There are currently 19,000 midwives working in the NHS, but the Royal College of Midwives says another 3,000 are needed over the next five years to fulfil the promises. Midwives complain that they often find themselves caring for more than one woman in labour as hospitals have cut back on services and shed staff.
Dame Karlene Davis, from the Royal College of Midwives, said the plan had her "wholehearted support", with some reservations. They also say the government faces a challenge increasing the number of home births.
"We are obviously concerned that there will need to be enough midwives to make it happen and the government has acknowledged that the plan can only be delivered with more midwives," she said. Only 2% of the 600,000 births a year take place at home and research by the Royal College of Midwives has shown that only one in five women is given the option of a home birth in the first place.
There are currently 19,000 midwives working in the NHS, but the RCM says another 3,000 are needed over the next five years to fulfil the promises.
Dame Karlene Davis, from the Royal College of Midwives, said she supported the plan, but added: "We are obviously concerned that there will need to be enough midwives to make it happen.
"There are variations across England in terms of the type and quality of service that women receive and we certainly want to see that the government puts in place levers to ensure that this happens for every woman in England and not just the most vocal or articulate women who can receive it.""There are variations across England in terms of the type and quality of service that women receive and we certainly want to see that the government puts in place levers to ensure that this happens for every woman in England and not just the most vocal or articulate women who can receive it."
Guarantees And Andrew Lansley, the shadow health secretary, said that with 43 maternity units due to close this year, he did not believe that the government would be able to deliver on its promises.
Health Secretary Patricia Hewitt said she could not promise to provide 3,000 extra midwives, rather it was up to local trusts to ensure they met government targets. "There is no evidence to support the planned closures and there is no evidence that Patricia Hewitt has substance behind this announcement about home births.
"What we're saying is, rather than decide at a national level how many more staff we're going to need, we actually need each local area of the NHS looking at their own position, doing their workforce planning, working out what they will need to do between now and 2009, in order to deliver the guarantees that we're going to give women," she added. "This is unfair to pregnant women and it is unfair to the professionals."
Midwives complain that they often find themselves caring for more than one woman in labour as hospitals have cut back on services. 'Familiar face'
A recent survey by the RCM found that NHS trusts have lost staff, introduced recruitment freezes and cut training budgets.
One trainee in the north of England told the BBC: "Morale among students is really low. We don't know if we will get jobs and we can see those who have are really stressed and overworked."
But the government has dismissed maternity care has got worse. The Department of Health said the midwife workforce had increased by a tenth since 1997 and there were 44% more students in training.
Choice
The government is looking to introduce greater choice in maternity care as part of its drive to have more "personalised health services". Patients are already given a choice of hospital for non-emergency surgery.
Only 2% of the 600,000 births a year take place at home and research by the RCM has shown that only one in five women is given the option of birth in the first place.
Ministers are also looking to make mothers-to-be more comfortable by giving them a named midwife as a point of contact through pregnancy.Ministers are also looking to make mothers-to-be more comfortable by giving them a named midwife as a point of contact through pregnancy.
And they will be invited to meet the team of midwives and doctors ahead of the birth so a "familiar face" is there during the delivery.And they will be invited to meet the team of midwives and doctors ahead of the birth so a "familiar face" is there during the delivery.
But a RCM spokesman said: "If these goals are going to be achieved, we are going to need more money and midwives. Health Secretary Patricia Hewitt said she could not promise to provide 3,000 extra midwives, rather it was up to local trusts to ensure they met government targets.
"In recent years the proportion of the NHS budget spent on maternity has been declining and that needs to be reversed." "We actually need each local area of the NHS looking at their own position, doing their workforce planning, working out what they will need to do between now and 2009, in order to deliver the guarantees that we're going to give women."
Professor Allan Templeton, president of the Royal College of Obstetricians and Gynaecologists, said: "If we are to provide mothers with more choice, then this can only happen when our places of birth are fully staffed.
"We will need more consultants and midwives."