RCM praises support from States, but raise concerns over “demographic” changes

Monday 11 November 2024

A report by the Royal College of Midwives has found much to commend in Guernsey but there some major concerns too.

Published on Friday, the report contains praise for the local midwifery service, and the island's low smoking rate and high rates of prenatal vaccinations and breastfeeding initiation being commended.

The major concerns however, include the island's rising rate of maternal obesity, and how a shift in the age demographic of new mothers could potentially impact maternity services.

Julie Richards, the RCM Director for Wales and the Channel Islands, said together they added complexity during pregnancy.

Although there is praise for the States support, there is also a warning as if the two trends follow - “the service may need to work harder in the future to meet these demands” and with it, a call for greater investment.

There is also some widespread praise for the support that Midwifes receive on island, with the States' rent allowances for staff moving to the island getting a specific mention, and praise for “Decision makers” who have prioritised public health. 

The report at a glance:

There are fewer babies being born in Guernsey, and there’s been a significant jump in the percentage of mothers in the 35 - 39 age bracket compared to during 2017. There are also fewer mothers by comparison in the 25 - 29, and 30 - 34 groups.

Pictured: “There has been a rise in women who are obese (a BMI of 30 or above), up from one woman in five (20%) in 2017 to almost one woman in three (29%) in 2023.” - RCM Report 2024

Smoking among expectant mothers has stayed at a lowered level says the report. In 2017 a decline was reported, with the percentage of mothers who smoked down from 13% to 11% by 2019. It remains at that lowered level now. 

A rise in obesity among expectant mums has been noted as a potential concern. 

In 2017 around '1 in 5' were obese, but that has changed to '1 in 3' last year. That’s an increase of 9% and raises concerns for the health of both mother and baby. 

Guernsey has favourable breastfeeding rates compared to England with 80% of Guernsey babies receiving breastmilk in the first 48 hours of life, compared to 68% in England. 

There are higher rates of prenatal vaccinations too, at '9 in 10' compared to '6 in 10' in England. Flu vaccination uptake saw an increase after a drop the previous year. 

Pictured: “Mothers are twice as likely to be aged 30 or older than under 30. Mothers are more likely to be overweight or obese. These changes present a challenge to the island’s maternity services.” - RCM Report 2024

Following the release of the report, Julie Richards, the RCM Director, said: “More women are choosing to start a family later, including in Guernsey where the age profile of women in pregnancy has increased. This, alongside raised Body Mass Index (BMI) among increasing numbers of women, brings with it added complexity during pregnancy.

"Making sure that the island’s maternity service has the right skills mix, and the right number of midwives, to adapt to these changes is imperative. The RCM wants to see continued commitment from the Bailiwick to invest in maternity services in Guernsey to meet these needs. 

“If the demographic changes that we are already witnessing continue, the service may need to work harder in the future to meet these demands. It is vital, therefore, that the Bailiwick invests in midwifery, ensuring that the island continues to have enough experienced midwives who are able to spend time with women to have the conversations that make the difference.”

Praise for decision makers. 

The report ends by highlighting the importance of Midwifery services in Guernsey and how decision makers have helped support them.

The report paints a positive picture of Guernsey's maternity services, highlighting their significant contribution to public health. However, it also acknowledges the challenges posed by demographic changes and workforce retention. It says to maintain the high standards of care, it is crucial to invest in midwifery services, support midwives, and adapt to the evolving needs of the population.

Alex Hawkins-Drew, Associate Director of Public Health, said: “It is wonderful to see this publication highlighting how the commitment in embedding vital Public Health work, by those working within our Maternity Services, has come to fruition in areas such as breastfeeding and vaccination.

“We understand that there will continue to be demands on the service due to the national increase in health-related complexities that some service users live with. However, there is a strong local commitment, embedded in States of Guernsey strategies, to address this. I am confident that with the ongoing support of all those working in Maternity Services, we will continue to support individuals to take steps to reduce personal health risks, which will benefit not only them but also their family.”