I’ve debated writing about this, at the moment it is still rumours, pretty strong rumours but it has some pretty hefty mongers instigating the whispering. If there is truth behind the words then the maternity services in one area will be stopping a service which has been provided for decades, that of domiciliary midwifery visits. If one region stops this care then eventually all Trusts will see the savings which can be made and community midwifery as we know it now will disappear.
Apparently a Trust has employed a cost-saving guru who has scoured the services and discovered that community midwives are an expensive item. They drive around the area, visiting new Mums and babies at home and this is obviously not cost effective to an accountants mind, after all, not only do they have to pay the midwife’s travelling time  but also her mileage. To any sensible person it is logical that, rather than the midwife travelling to the patient, the patient should travel to the midwife. This does happen already in some areas over weekends and this has allowed the Trusts to reduce the numbers of midwives working and being paid unsocial hours.
So, the benefits are that a midwife can see double the number of women and doesn’t have to be paid mileage. There are drawbacks, none of which are obviously financial so probably not of interest to an accountant employed to advise a Trust on cost-cutting. Women are now being discharged earlier and earlier from hospital following the birth, even those who have had caesareans now come home on day 2. In the future will they be expected to return the next day to the hospital, often having to travel over 15 miles due to the closure of the smaller maternity units? What about those families who do not have transport, or have other children? There are so many ‘what ifs’, many seemingly trivial but which will impact upon the welfare of mothers and babies.
Links identifying the role of the midwife in postnatal care
NCT
Maternity Matters
Community postnatal care provision in Scotland : the development and evaluation of a template for the provision of woman centred community postnatal care
The Lancet
