BMJ  2003;327 (13 September), doi:10.1136/bmj.327.7415.0

Midwifery shortages increase mishaps in maternity wards

Midwifery staffing shortages are associated with adverse events and "near misses" in maternity units. Ashcroft and colleagues (p 584) examined the organisation of care and adverse outcomes in seven maternity units in the north west of England by interviewing midwives, directly observing clinical practice, and analysing workplace documentation. They found that high risk practices such as epidural blockades were done despite a shortage of midwives in all units. Many adverse events and near misses were attributable to staffing shortages, and most went unreported. Midwives spent time performing clerical duties and did not take up training opportunities. The authors say that team midwifery systems erode the skills and confidence of midwives in labour wards.

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Prospective semistructured observational study to identify risk attributable to staff deployment, training, and updating opportunities for midwives

Brenda Ashcroft, Max Elstein, Nicholas Boreham, and Soren Holm
BMJ 2003 327: 584. [Abstract] [Full Text] [PDF]

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