More than half of all pregnant women are left alone at some point while giving birth, a survey commissioned by the Department of Health reveals today.
The poll, conducted by the national perinatal epidemiology unit (NPEU) and co-funded by the healthcare watchdog, the Healthcare Commission, suggests more than 300,000 women a year are being left for some period of time, with 75,000 of them suffering anxiety as a result.
While there are no guidelines that insist women are not left while giving birth, draft guidance from the National Institute for Health and Clinical Excellence proposes that women "should not be left alone once labour is established".
Guidance issued by the Royal College of Obstetricians and Gynaecologists, adopted by Nice, also states that women should have a designated midwife and that the baby's heart should be checked every 15 minutes through electronic foetal monitoring. The Royal College of Midwives advises that women should not be left during the late stages of labour.
The health secretary, Patricia Hewitt, will next month confirm a manifesto pledge that every woman will be guaranteed a named midwife she can call on throughout her pregnancy.
The survey, conducted among 4,800 women who gave birth during a week in March last year, suggests 56% of women are being denied this level of care as a result of the crisis in midwife numbers. While the government has tried to encourage more women to go into midwifery - or return to it - the Royal College of Midwives has put the shortfall at 10,000, with only the equivalent of 18,949 full-time midwives working at a time when the birthrate has risen by 50,000 over five years.
The report also reveals that, while most mothers are happy with their experience of maternity service, their experience of postnatal care has "barely improved" over the last 10 years, despite significant investment in facilities. A quarter of women surveyed said they were unhappy with the cleanliness, lack of privacy, temperature and noise concerns and stated that staff were rushed. Only 57% of women felt staff communicated with each other well.
The findings will feed into the largest review of maternity care in England that will ask all 50,000 women who gave birth in February for their experiences. The Healthcare Commission, which will conduct the survey, hopes it will provide benchmarks to drive up standards.
Gwyneth Lewis, the Department of Health's expert on maternity services, welcomed the report as "important and wide-ranging" and said it would feed into the maternity plan to be published next month. This is expected to guarantee that by 2009 every woman will have a choice of where and how she gives birth.
Chris Johnson, spokesman for the Royal College of Midwives, said the concerns raised by the report were already shared by the RCM and needed to be improved. "We believe there should be one-to-one care during the late stages of labour, with a midwife in the room."
Mary Newburn, head of policy research at the National Childbirth Trust, said: "We hope the results of this survey help to prioritise one-to-one care for women. However, recent cuts in community-based postnatal services in many areas do not bode well for achieving this."
The shadow health secretary, Andrew Lansley, said some mothers were being denied "one-to-one midwife care or level of midwife support which should be regarded as basic". He added: "With 43 maternity units facing cutback and closures, it seems that the government have no idea of the standard of care being delivered and appear indifferent to the fact that service closure will reduce standards."
