A shakeup of maternity services that would give every mother continuous one-to-one care during childbirth was promised yesterday by Yvette Cooper, the public health minister.
Organisations representing mothers and midwives welcomed the announcement, but said that the government had yet to explain how it could solve a chronic staff shortage that was overstretching maternity units in south-east England and some inner city and rural areas.
Ms Cooper, who is seven months pregnant with her second child, gave details of a £100m plan to modernise childbirth services that was outlined last month by Alan Milburn, the health secretary.
She promised national standards by 2003 giving women maximum choice in the type of delivery and kind of support that would be available during labour. Such standards, under the new national service framework, are being applied to care specialisms across the NHS.
Ms Cooper told a meeting of the National Childbirth Trust in London that the government would recruit 2,000 extra midwives, and provide women with more continuity of care through their pregnancy and childbirth by developing a programme of team midwifery.
There would be improved facilities for fathers to play a full role in births, and more sensitive treatment of bereaved parents in maternity wards.
Women who lose their babies will no longer be placed on post-natal wards alongside mothers who are celebrating successful deliveries. About 5,000 babies each year are stillborn or die in the first few days.
Ms Cooper said that 71% of hospital maternity units provided one-to-one care during labour. Many women said they got excellent care in pregnancy, but there were too many variations in standards.
"When I had my daughter at Pontefract General infirmary two years ago, I had one-to-one support throughout labour from midwives I knew," she said.
"I want to make sure that the gold standard of one-to-one care in established labour is introduced in every corner of the country, and that we increase the continuity of care by looking at programmes like team midwifery.
"That means increasing the number of midwives, and looking at new models of care, through the new national service framework."
Every woman had her own views about the kind of support she wanted during childbirth. "Some want a home birth, others want epidurals and rapid pain relief. No woman should feel pressurised into inappropriate choices, or made to feel guilty for the decisions they take," she said.
Mary Newburn, head of policy research for the National Childbirth Trust, welcomed the recognition that improvements in child health depended on bigger investment in maternity services.
But, she said, ministers had not yet explained how they were going to recruit 2,000 extra midwives. "That remains an enormous challenge," Ms Newburn said.
Midwives were leaving the profession because they did not feel able to practise in a way that satisfied them, she said. They were often obliged to look after a succession of women without knowing the outcome of their work.
Mothers being cared for by a series of midwives said they were given conflicting advice and had no sense of being valued.
Ms Newburn said the government had little idea of the state of maternity services, be cause official statistics were three years out of date. They showed 20% of births were induced, 18% were caesareans, and 10% involved the use of instruments, mainly forceps.
Women were more likely to have a natural delivery in midwife-led birth centres than in general hospitals, where they were usually confined to bed and electronically monitored.
Louise Silverton, deputy general secretary of the Royal College of Midwives, said the government was right to give higher priority to maternity services. But the system was short of about 5,000 midwives, and the workload varied enormously without any apparent reason between different maternity units.
There was no central monitoring of cuts in maternity beds that were often made because hospitals could not staff them, she said.
