The midwifery workforce in Wales could be under threat if England attempts to poach midwives to plug staffing gaps caused by Brexit, warns a report by the Royal College of Midwives.

The UK’s decision to leave the European Union has not had a significant impact on midwife numbers in Wales, according to the report on the state of maternity services across the country.

“We must stay ahead of the curve to ensure we will not face the same challenges that England currently has” Helen Rogers

However, it warns there is a risk that England, which employs many more EU midwives and is beset by shortages, may start to look at Wales’ burgeoning midwifery workforce with greedy eyes.

According to the report, there are currently more than 1,000 midwives from EU countries working in England, which is short of 3,500 full-time equivalent midwives.

“The loss of EU midwives, especially in England, runs the risk of the NHS across the border poaching midwives from Wales’s NHS,” said the report.

Meanwhile, it suggested that Wales’ success in boosting midwife numbers meant English trusts may attempt to lure new staff away.

“The substantial jump in midwifery training numbers in Wales could prove too tempting for recruiters in England,” said the report.

“We also very much welcome the Welsh government’s decision to retain the student midwife bursary” Helen Rogers

It shows the midwifery workforce in Wales has risen steadily in recent years. Since 2009, the number of midwives working in the NHS in Wales rose by the equivalent of 129 full-time staff – an increase of 10.6%.

The RCM said it was hopeful this rise would continue thanks to the Welsh government’s decision to boost student midwife numbers in 2017-18 by 40%, with a total of 134 training places available.

The report stated that this rise has been maintained in the current 2018-19 academic year.

Of the 94 people who started midwifery training in 2014-15, 84 graduated as midwives – meaning 89% successfully completed their studies, according to the report.

This “is a positive sign that the increase in the number of training places will lead to many more newly-qualified midwives available to work in Wales’s NHS”, it added.

“Levels of smoking and obesity add to the complexity of the workload faced by midwives” Helen Rogers

The report shows there has been a “marked increase” in the proportion of younger midwives in their 20s and 30s – up from 31.2% in March 2011 to 40.9% in November 2017.

However, the report makes it clear that the challenge of an ageing workforce “has not gone away”, with more than a third of midwives in their 50s and 60s.

Helen Rogers, the RCM’s director for Wales, said the nation had been doing well when it came to “future proofing our maternity services”.

“But we must stay ahead of the curve to ensure we will not face the same challenges that England currently has, such as the chronic shortage of midwives,” she added.

The decision to increase student midwife numbers “will go a long way to offsetting the large numbers of midwives due to retire in the coming years”, she maintained.

“The RCM would like to see this increase maintained over the coming years to ensure our maternity services have the number of midwives needed to deliver safe, high quality care for women, babies and their families,” she said.

She added: “We also very much welcome the Welsh government’s decision to retain the student midwife bursary, which will ensure those interested in dedicating their life to the NHS and becoming a midwife will not have to pay thousands of pounds, unlike in England.”

In addition, the report showed the number of live births in Wales has dropped each year since 2010, which has eased pressure on services.

However – in common with other UK countries – Wales has seen an increase in the complexity of care women require with more older mothers than before.

The RCM also raised serious concerns about the high levels of obesity and smoking in Wales with one in four women recorded as obese and one in five recorded as smokers.

Meanwhile, the report highlighted “quite dramatic differences” in smoking and obesity rates in different areas.

In the Cwm Taf University Health Board area, around a quarter of women were smoking at the time of their initial assessment while around a third were classed as obese.

In contrast, around one in seven women seen by midwives in the Powys Teaching Health Board area were smokers, while around one in five was obese.

Ms Rogers described Wales’s smoking and obesity rates during pregnancy as “a real worry”.

“We know obesity and smoking can have an impact on stillbirth rates and women who are overweight do require extra support throughout their pregnancy,” she said.

“As with older mothers, levels of smoking and obesity add to the complexity of the workload faced by midwives and the entire maternity team,” she noted.

Not only will more be required of existing staff but more midwives will be needed to provide the same level of care, said the report.