headline: Midwives warn staffing crisis risks mother and babies' lives
text: Midwives at an NHS trust rated as inadequate have warned women and babies could be placed at risk, if staff recruitment does not rapidly improve. 
  Gloucestershire Hospitals NHS Foundation Trust was downgraded from good by a health watchdog in summer.
  Four people from the midwifery service have spoken to the BBC anonymously.
  gh workloads, staff sickness and unfilled vacancies mean "mistakes will be made" but the trust said it had recruited 48 midwives in the past year.
  It also said it was committed to creating a "positive culture" in the service.  
  whistleblowers, who asked to remain anonymous out of fear of repercussions at work, said: "Midwives come on shift, take handover and often cry in anticipation of a terrible shift.
  "If nothing changes it will be unsafe to have a baby. Things will get missed and to be blunt, mums and babies could die. 
  "There will be a rise in postnatal depression, and mums will not get the support they deserve."
  Another added: "It's been normalised for us to not drink any fluids for a full shift, not eating anything or grabbing sugary things, not realising our periods have started, not sleep well between shifts, calling back to work because we've forgotten something and working on our days off. 
  "If you're going to choose to birth in Gloucestershire, it is a guessing game.  
  "Will you get someone happy in their job? Will you get something who is well slept, fed and watered? Will you get someone who is fully present?  Will you get someone who is feeling supported?"
  Gloucestershire's maternity services were downgraded from good to inadequate in the summer. 
  In its report, the Care Quality Commission (CQC) highlighted concerns with culture, safety and the quality of services and staffing.
  midwives said recruitment was being focussed in the wrong areas and that was creating additional pressures. 
  "We are constantly being told that there is no funding for an extra midwives, however they have recently recruited another manager," one said.   
  "We have also asked for extra admin support to alleviate some of the mountain of paperwork, but again we are told the same story regarding funding."
  Another added: "There is no effort to improve retention. There is an insidious blame culture at the trust, across all sites managers have little-to-no training on how to manage or lead, they speak and treat staff appallingly.  
  "Management needs a drastic overhaul from the top down.  
  "If nothing changes, our CQC rating will remain or decrease.
  "The choice for women in the county will remain poor.
  "The options for women who would choose to have their baby in a freestanding birth unit or at home will be non-existent."
  Gloucestershire Hospitals NHS Foundation Trust said it was "incredibly proud" of midwifery staff, who worked in the "most challenging of circumstances".
  Matt Holdaway, director of quality and chief nurse, said: "Thanks to a range of targeted initiatives from our dedicated midwifery recruitment team we have made significant progress over the summer in recruiting new midwives, with 14 new starters in October and a further seven being offered places in November. 
  "In the last 12 months, 48 band 5 and 6 midwives have joined our team." 
  He said the leadership team was also "determined" to develop a positive culture that "focuses on fairness, openness and learning".
  But the midwives say it had made little difference on the ground yet.
  "We often work over our allotted hours, have little time for effective breaks and our physical, mental and emotional health are being affected as a consequence," one said. 
  "It's like being in an abusive relationship where we get up every morning thinking it's going to get better but it never does."  
  Clare Livingstone, from the Royal College of Midwives, said: "England's NHS is 2,000 midwives short of the numbers needed and that is worsening with around 400 fewer now than at the same time last year." 
  "Staff are on their knees, exhausted and burnt-out and to continue like this is simply not sustainable. They desperately want to deliver the best possible care and often cannot. This is not good for them or for women, babies, and their families.  
  "There is a need from this Government to ensure funding already committed to maternity services gets there quickly. They must also to step up investment to increase staff numbers and to ensure we keep the midwives we already have, because many are heading for the exit door," she added. 
  government said the NHS was investing an additional £127m in maternity services in 2023 to increase the maternity workforce - on top of £95m already invested to recruit an additional 1,200 midwives and 100 consultant obstetricians.
  "We are also supporting training to ensure we have the staff in place to deliver high-quality care, and have increased the number of midwifery training places by more than 1,700 since 2019."