Deciding how many midwives are needed

Information for the public

NICE says that anywhere providing NHS maternity services should have a system to make sure there are enough midwives at all times to safely care for and support women and their babies.

The system should:

allow for all the care women need from midwives before pregnancy, during pregnancy and when they are in labour, and for the care women and their babies need after birth
take account of the woman's needs and any extra support required, for example if she has diabetes
allow for every woman in established labour to have one-to-one support (Established labour is when there are regular and painful contractions, and the cervix has opened to at least 4 cm.)
be able to manage daily changes in the need for midwives and provide cover for when midwives are on leave, training or ill.

People planning maternity services need to make sure that they:

have plans to deal with unexpected changes in demand for midwives, for example, by using other staff to help or on-call or temporary midwives, or rescheduling non-urgent work
review how many midwives are needed and whether demand has changed – they should carry out the review at least every 6 months
change the number of midwives employed if the review shows that this is needed.