Don't throw the midwife out with the baby's bath water

One of the great things about being a midwife is the privilege of sharing the miracle of new life. The role of the midwife and the uniqueness of the dynamic relationship with women may be immeasurable because of the unseen relational advocacy and partnership empowerment. Safeguarding the holistic role of the midwife at a time when austerity forces efficiency gains has never been more important. Equally, providing high-quality maternity services against a backdrop of a predicted £44–54 billion funding gap by 2020/21 (Roberts et al, 2012) presents challenges for providers, particularly as health policy expects improvement in quality and workforce models that put service users first and offer them choice in their health care (NHS England, 2014).

There were 695 233 live births in England and Wales in 2014, down 0.5% from 698 512 in 2013 (Office for National Statistics, 2015). Despite this small decrease, overall births are at their highest in 40 years (NHS England, 2014). Financial pressures suggest it is unrealistic to expect significant increases in staff numbers, so provider units have responded in a number of ways.