birthThe number of older mothers continues to grow in England with 85% more births to over-40s than 12 years ago, according to a new report by the Royal College of Midwives.

RCM's third annual report details the pressures of an ageing workforce dealing with increasingly complex pregnancies and a buckling maternity service.

In 2012, there were almost 700,000 babies born in England, the most in any year since 1971 and up 29% compared to 2001, while an 4,800 shortage of midwives persists.

The RCM say this is particularly pressing as births to older mothers, continue to rise far faster than for other age groups, and these women will typically require more complex care, attention and support from midwives.

Commenting on the report the RCM’s Director for Midwifery Louise Silverton said: "England does not have to be the UK’s problem child for maternity care. Yet it remains around 4,800 midwives short of the number required to provide mothers and babies with the high-quality service they need and deserve

"We have reached a make or break point. We have reached a crossroad and the Government must not take its foot off the accelerator and continue to pump money into maternity care.  Indeed, this crossroad should be seen as an opportunity to eliminate the shortage of 4,800 midwives much faster.  This is not a time for political backsliding. The promises and platitudes for more midwives need to continue and this will take vision and political will."

There are particular hotspots for births to older women. In five areas in the UK (East Renfrewshire , Maidenhead, Brighton, Wokingham and Surrey) 30% or more of all births in 2012 were to women aged 35 or older.

Obesity is another area of growing complexity, which compounds the effect of the baby boom. The incidence of maternal obesity in the first three months of pregnancy in England more than doubled to 16% between 1989 and 2007. This resulted in an extra 47,500 women requiring more demanding care from midwives.

Previous State of Maternity Services reports revealed a trend towards women having babies later in life, and fewer giving birth in their teenage years. These trends are becoming more pronounced.

Currently the number of midwives is rising faster than the number of births, putting us on track eventually to eliminate the shortage, if those trends are maintained, says the RCM. However, the union still estimates there is a shortage of 4, 800 midwives in England needed to deal with the greater complexity of care required.

A recent survey of 1,025 RCM members released in November found that the majority of current midwives are highly-motivated and committed to serving mothers and babies, but there is an undercurrent of resentment about working pay and terms and conditions.

Read the full report at www.rcm.org.uk/soms