Maternity services faced growing pressure on capacity and staff last year despite government commitments to improve safety and choice.

Newly released reports from regional midwifery officers show midwife numbers in many areas failed to keep up with the rising birth rate in 2007-08.

The South West local supervising authority report said: "Historically, maternity units have been able to cope well with the peaks and troughs of a fluid workload; but for the first time, there has been the temporary closure of many units due to capacity or staffing issues."

London's report said midwives were "frequently" concerned about lack of capacity, which had led to the need to suspend services and, on occasion, to "fears of 'things going wrong' as care in labour is reportedly sometimes compromised".

The government's April 2007 Maternity Matters strategy told trusts to plan their workforce to ensure safety and to offer all mothers a choice of birthplace by the end of next year.

In February this year health secretary Alan Johnson said an additional 1,000 midwives should be appointed "by 2009".

Royal College of Midwives deputy general secretary Louise Silverton told HSJ: "Our members are telling us that they are overworked and overstretched and are running between beds dealing in some cases with three women at once."

The East Midlands report said it had been working with commissioners to increase numbers. However, "an increase of 2,352 deliveries [has] required extra midwives and thus the birth to midwife ratio has not improved to the anticipated level".

The ratio on the region's units ranged from 32:1 to 45:1, it said, against the recommended 28:1.

Yorkshire and the Humber's report said that in seven of its eight trusts the ratio worsened, which led to training being cancelled, midwives being "pulled" to cover high risk areas and pressure on delivery suites. But it said investment was increasing in 2008-09 .

East Midlands midwifery officer Shirley Smith agreed.

"I am a lot more positive now than I was at the same time last year," she said.

The report for Wales, where there was a drop of five registered midwives to 1,684, said staff shortages were a problem in some areas.

North West and South Central authorities declined to provide reports.

HSJ's World Class Workforce conference is on 27 January

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