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Older mothers placing more strain on midwives Older mothers placing more strain on midwives
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Older, more overweight mothers are placing an increased strain on midwives who believe they are already conducting close to 130,000 deliveries a year for which they do not have sufficient resources, the Royal College of Midwives has said.Older, more overweight mothers are placing an increased strain on midwives who believe they are already conducting close to 130,000 deliveries a year for which they do not have sufficient resources, the Royal College of Midwives has said.
Births in England peaked at almost 700,000 in 2012, the highest level since 1971, and although a fall in the first half of 2013 suggests a decade-long baby boom may be over, a rising number of women are giving birth in their 40s, demanding higher levels of care. Births in England peaked at almost 700,000 in 2012, the highest since 1971, and although a fall in the first half of 2013 suggests a decade-long baby boom may be over, a rising number of women are giving birth in their 40s, demanding higher levels of care.
The number of such women rose 85% in England between 2001 and 2012, equivalent to an extra 13,000 middle-aged mums, while Scotland saw a 165% rise in mothers aged more than 44 over the same period. The number of such women rose 85% in England between 2001 and 2012, equivalent to an extra 13,000. Scotland saw a 165% rise in those 44 or older giving birth over the same period.
The only age bracket for which birth rates are falling is the under-20s, down by more than 20% in England, Scotland and Wales over the last 11 years. In 2012, 30,000 babies – 4.1% of all live births – were born to mothers aged over 40, the Office for National Statistics has calculated. The only age group in which birth rates are falling is the under-20s, down by more than 20% in England, Scotland and Wales in the last 11 years. In 2012, 30,000 babies (4.1% of all live births) were born to women over 40, the Office for National Statistics says.
The areas with the most older mothers are East Renfrewshire, south-west of Glasgow, Windsor and Maidenhead and Wokingham in Berkshire, Brighton and Hove on the south coast, and the affluent commuter county of Surrey where 30% or more of all births in 2012 were to women aged 35 or older, the RCM said. In Luton the share of births to women aged 35 or above jumped from 16% in 2011 to 20% in 2012. The areas with the most older mothers are East Renfrewshire, south-west of Glasgow, Windsor and Maidenhead and Wokingham in Berkshire, Brighton and Hove on the south coast, and the affluent commuter county of Surrey where more than 30% of all births in 2012 were to women 35 or older, the RCM said. In Luton the share of births to women 35 or older rose from 16% in 2011 to 20% in 2012.
"Older women require more assistance from midwives," said Louise Silverton, the RCM's director for midwifery. "They have a perfect right to all that additional care, of course, but it has an undeniable knock-on effect on workload, and that needs to be reflected in the number of midwives in the NHS overall.""Older women require more assistance from midwives," said Louise Silverton, the RCM's director for midwifery. "They have a perfect right to all that additional care, of course, but it has an undeniable knock-on effect on workload, and that needs to be reflected in the number of midwives in the NHS overall."
The number of women displaying maternal obesity was also up, the midwives said. Cases of first-trimester obesity doubled from 7.6% to 15.6% between 1989 and 2007. It means close to 50,000 women have required more demanding care during their pregnancies, the RCM said in its annual State of Maternity Services report (pdf). The number of women displaying maternal obesity was also up, the college said. Cases of first-trimester obesity doubled from 7.6% to 15.6% between 1989 and 2007. It means close to 50,000 women have required more demanding care during their pregnancies, the RCM said in its annual State of Maternity Services report (pdf).
The RCM, a trade union and professional organisation, remains concerned that there remain "massive shortages" of midwives in England, with 4,800 more needed to meet demand. And it is not just mothers who are getting older, midwives are too, leading to fears of a retirement crunch that could exacerbate the shortage. The largest single age group among midwives is now 45-49. The RCM, a trade union and professional organisation, remains concerned that says there remain "massive shortages" of midwives in England, with 4,800 more needed to meet demand. And it is not just mothers who are getting older, midwives are too, leading to fears of a retirement crunch that could exacerbate the shortage. The largest single age group among midwives is now 45-49.
However, the numbers entering the profession are improving. Between May 2010, when the coalition government was formed, and July 2013 the number of full-time-equivalent midwives working in the NHS in England rose by 1,311, or 6.5%, meaning the number of midwives is rising faster than the number of births. But the numbers entering the profession are improving. Between May 2010, when the coalition government was formed, and July last year 1,311 the number of full-time-equivalent midwives working in the NHS in England rose by 1,311, or 6.5%, meaning the number of midwives is rising faster than the number of births.
Student midwife numbers have topped 6,000. If the trend continues the shortfall should be eliminated, but some regions are struggling. The number of midwives in the north-west of England fell by 117 between 2001 and 2012, while the number of babies born in the region jumping by 14,010 over the same period. Student midwife numbers have topped 6,000. If the trend continues the shortfall should be eliminated, but some regions are struggling. The number of midwives in the north-west fell by 117 between 2001 and 2012, while the number of births rose by 14,010 over the same period.
"England does not have to be the UK's problem child for maternity care," said Silverton. "Yet it remains around 4,800 midwives short of the number required to provide mothers and babies with the high-quality service they need and deserve. Midwives in England have been run ragged for years as the number of babies born has gone up and up and up. Thousands of midwives short, as we are today, they are still running to catch up.""England does not have to be the UK's problem child for maternity care," said Silverton. "Yet it remains around 4,800 midwives short of the number required to provide mothers and babies with the high-quality service they need and deserve. Midwives in England have been run ragged for years as the number of babies born has gone up and up and up. Thousands of midwives short, as we are today, they are still running to catch up."
"Older women are more at risk of preeclampsia, miscarriage and complicated pregnancies which could result in use of forceps or caesarean section," said Jacque Gerrard, RCM director for England. This means more time must be spent in the antenatal period educating women about the risks and the need to offset them by taking folic acid, coming off alcohol and other measures, she said, adding that older mothers tended to be more "educated, wiser women" and so more likely to take such advice on board.
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