By Dr Mary Ross-Davie

THERE was good news earlier this month for Scotland’s maternity services when new figures showed a small increase in NHS midwife numbers. This is something I welcomed and is cause for celebration. It will be cheered also by hard-pressed NHS staff caring for pregnant women, new mothers, and their babies. There is a flip side, though, a hidden problem that needs to be addressed, and it’s a problem that is set to worsen.

Most of these additional midwives were educated and trained in Scottish universities. Half of their programme takes place in the universities, half on clinical placements in Scottish NHS maternity services. Both deliver some of the best midwifery education and highest quality maternity care in the world, but they are doing it against the odds, and without adequate resources.

Partly in response to repeated calls by the Royal College of Midwives (RCM), the numbers of midwifery students in Scotland has been increasingly since 2012, to offset the high number of midwives reaching retirement age. From the RCM’s assessment of the figures, the number of student midwives starting their course this year will be the highest this century, at nearly 300. Our Government must be congratulated on this; but more needs to be done to ensure these students get the best possible education and support.

All these students need midwifery educators in our universities to teach them. All these students need support and guidance on their clinical placements in the NHS during their training. Both elements are critical to ensure these students get the best possible education, so that when they qualify, they have the best start to their career. Our universities are already struggling because they have not seen an increase in the number of midwifery educators to match the increase in students. Maternity services were already stretched coping with the demands on them, struggling to ensure they could support midwifery students on their clinical placements. The pandemic has added more pressure.

These problems are set to become even more acute. From this week, new groups of student midwives go into our universities with three years of education and training ahead of them. This year, because of the issues around exam results, our universities are taking on significantly larger numbers of students than planned. There is little or no planned increase in the number of midwifery educators to manage this. Nor is there additional investment in the people and resources needed to support them on their clinical placements in our pressured maternity services.

This situation needs attention. You cannot cram more students into a system without backing that up with investment and support. We need to make sure Scotland has enough midwifery educators in our universities, which means making wages in education at least match those in the NHS. We also need to be aware of the potential pressures on already stretched maternity services with so many more students will go into them doing clinical placements, and to plan for that. Services need to be given additional resources to support students on their placements, to relieve the pressure on the midwives guiding and mentoring them. Scotland is trying to fit a quart into a pint pot, and it cannot be done.

Put simply, the quality of education we give to these students translates directly into the safety and quality of care for women in the future. If we skimp on that now, we are putting that care and safety at risk.

Dr Mary Ross-Davie is Director for Scotland, The Royal College of Midwives