Three quarters of midwives in Scotland say they are thinking of leaving the profession due to understaffing, burnout and fears that they cannot provide safe care, according to a survey conducted by the Royal College of Midwives (RCM).
Around half of respondents said there is rarely enough staff to provide safe care for women and some described every single shift they worked as being short-staffed.
Newly qualified midwives also reported a desire to leave the profession and many expressed regrets about their decision to enter midwifery.
Midwives also raised concerns about rising workload, saying they were “overwhelmed” and struggled to manage a “seemingly endless” workload.
Respondents also said they felt they were finishing shifts unable to provide care that women and families deserved.
Stress and poor mental health has affected nine in 10 midwives, with one saying they have “nothing left to give” their own family at the end of the day, the survey found. Some reported taking medication to deal with anxiety, depression and other mental health issues.
Nine in 10 respondents told the RCM that they had worked without breaks over the last 18 months with more than half (52%) saying this happened once or twice a week.
One woman said that she was unable to take a break to change her sanitary wear during a 12-hour shift. She said: “When I say no break, I mean flooding through sanitary products onto my clothing because I cannot take 10 minutes to change my tampon in a 12-hour shift.”
The RCM said it is “deeply concerned” by the survey results. Jaki Lambert, RCM director for Scotland, said: “This shows deep-seated and longstanding issues, certainly worsened by the pandemic which midwives fear are already impacting on the quality of care for women and their babies.
“There is a worrying catalogue of issues and discontent with an exhausted and a fragile maternity workforce with rock-bottom morale. They have also been emotionally and physically battered by the pandemic and left feeling that their work and efforts are not valued. We need to move forward together with the Government from this point.
“There is a real disconnect between what maternity services need and what resources are available to them in terms of funding, professional development, resources, and staffing. It is only the incredible determination, skill and sheer willpower of midwives and their colleagues that are holding services up. Without action the staff, and the system they are propping up, will break. This is not safe, it’s not sustainable, and it’s not acceptable.”
The body has laid out several recommendations to address the issues raised in the survey, including a call for more support for midwives early in their career to focus on retention. They have also called for a substantial increase in the number of consultant midwives and clinical educators.
Ms Lambert added: “The pain and anguish of midwives was very difficult to read about and I hope their words are captured in this survey. It paints a deeply worrying picture of staff that are on their knees and are not currently seeing a way forward or access to the support they need to deliver the safest and best possible care.
“We can and must do better for midwives, women, babies, and families in Scotland. We know that the Scottish Government wants to fix this and we want to work with them to make sure that midwives are valued and their expertise recognised.”
Women’s health minister Maree Todd said she “recognises the pressures in the system” and that the Scottish Government will work with partners to find solutions.
She said: “I want to thank all of our midwives for the incredible work that they have done, and continue to do, during the pandemic. I am also grateful for RCM Scotland for this work on the first National Survey Report and the chance to discuss their findings.
“It is critical staff wellbeing is looked after and they are able to take the rest breaks and leave to which they are entitled, as well as being given time to access national and local wellbeing resources at work. That is why we made £12 million available in 2021-22 to support the mental health and wellbeing of the workforce.
“This report highlights important issues and we will fully consider all of the recommendations, and how these interact with work already under way.”