NHS maternity services are under pressure

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Sir, Amid continuing NHS reconfiguration and the proposed closure of maternity units, we are asking the Department of Health urgently to consider the recommendations in the joint report Safer Childbirth: Minimum Standards for the Organisation and Delivery of Care in Labour released tomorrow. These recommendations have been agreed by the Royal College of Obstetricians and Gynaecologists, Royal College of Midwives, Royal College of Anaesthetists and Royal College of Paediatrics and Child Health.
There are increasing pressures on NHS maternity services as a result of social trends such as delaying pregnancy until a later age, increasing numbers of mothers from ethnic minorities and increasing levels of obesity among women. The birthrate has risen to its highest level since 1980. Existing resources for maternity services are inadequate and, while some local reconfigurations may be justified in the longterm, urgent action is needed to address staffing and skill shortages at a local level in current units.
A rapid response is needed to ensure that our maternity units are safe and have the expertise and resources needed to deliver high quality services. The joint report sets out the standards needed to run labour wards efficiently and effectively. We draw particular attention to the recommendation that multidisciplinary teamworking among well-trained professionals improves standards of care and womens experiences of childbirth.
All women should have one-to-one midwifery care through labour, but many will also need urgent assistance from other members of the maternity care team such as obstetricians, anaesthetists and neonatologists.