By Dr Ananya Mandal, MD
According to latest figures more than a 100 mothers have died in childbirth in London in the last five years. This is twice the rate in the rest of the country. There were 11 deaths in 2005-6, compared with 29 in 2010-11. Births in London have soared by 27 per cent in the last decade from 106,000 in 2001 to 134,000 in 2011, but numbers of midwives and doctors have not kept pace.
Cathy Warwick, president of the Royal College of Midwives, said yesterday, “London still has some of the worst shortages of midwives across the country. There are more women facing more complex pregnancies creating a difficult situation. We need to target resources at women who need more support.”
Professor Cathy Warwick said, “Two factors are combining: maternity services are under pressure from a steadily rising birth rate while dealing with far more women with complex pregnancies.” Since 2001 the UK birth rate has jumped by 21 per cent, up from 594,634 to 723,165 last year alone. By contrast, the number of midwives has only increased by 15 per cent over the same period, from 18,048 to 20,790. The college estimates an extra 5,000 midwives are needed.
Two inquiries have been held into the high maternal death rate in London in the last four years and both have found maternity services wanting compared with the rest of the UK. Younger midwives cannot afford to live in the capital and older, more senior ones move out.
The new figures came from research by Susan Bewley, professor of complex obstetrics at Kings College London and Angela Helleur of NHS London and published in The Lancet. Professor Bewley said that the number of deaths was small relative to the number of births, but maternal mortality was a sensitive measure of healthcare quality. Risks were higher in older mothers, and linked with obesity, poverty, ethnic minorities, immigration and twin pregnancies (following IVF), all of which were more common in London. “What we don't know is if the rise in maternal mortality is a measure of illness in the population or the response of the medical services to it. It is possible that more women are falling through the net because they are [more ill],” she said.