The government has guaranteed to employ an extra 3,400 midwives in the UK
Many health authorities are not on track to provide the midwives needed for one-to-one care, figures obtained by the midwives' trade union suggest.
The Royal College of Midwives wants one midwife for every 28 births, but says only four Strategic Health Authorities (SHAs) will hit or better this by 2012. Four of England's 10 SHAs will still have more than 32 births per midwife by that time, NHS workforce figures show.
According to National Health Service guidelines, all women in labour should have a dedicated midwife.
For this to be achieved, the RCM believes a full-time midwife is necessary for every 28 births per year. It says that while the government has guaranteed to employ an extra 3,400 midwives by 2012, in reality an extra 5,000 are needed to deliver safe, high quality care. This would provide cover for antenatal and postnatal support - including breastfeeding help - as well as delivering babies. It would also take into account account sick and maternity leave.
Other studies carried out have said a maximum of 32 births per midwife is acceptable, but four SHAs look likely to exceed this. They include Yorkshire and Humber - with 33.8 by 2012 , East Midlands - with 33.9, East of England - with 35.2, and London - with 33.6. With the exception of Yorkshire and Humber, these are an improvement on current ratios.
However there has been growing pressure on maternity services due to the rising fertility rate - the result in part of women having babies older and immigration levels. At the last count, almost a quarter of live births were to mothers born outside the UK.
RCM general secretary Cathy Warwick said: "We know the government is making a big effort to recruit more midwives and are putting money into maternity services.
"Their policies are good and are going in the right direction. However, these figures show that although the situation for most regions will be better, it will still not good be good enough to deliver the quality of care women need."
She called for a "step change" at regional level to recruit more midwives.
Caroline Waterfield, deputy head of employment services at NHS Employers, said: "It is important that Royal Colleges and professional bodies issue expected standards required by both clinical staff and NHS trusts to ensure the safety of patients.
"However, while ratios recommending appropriate staffing levels are a helpful guideline for those providing midwifery care there needs to be local flexibility for employers to take into account local need and the intensity of individual units."
In 2007-08, the Department of Health invested £1.78 billion on maternity services. In January 2008, they announced a further £330 million for maternity services for the next three years.
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