As a consultant working at the frontline of NHS maternity provision, Virginia Beckett knows all about the pressures faced by units around the country.

The number of maternity beds nationwide had “reduced dramatically” and facilities have been cut back over the past decade, she said, thanks to an attempt to “demedicalise” the process of giving birth and an assumption that women want to be discharged as soon as possible.

But Dr Beckett, a consultant obstetrician based at Bradford Royal Infirmary, said that while some women welcome the move towards more natural and home births, “my experience is that women don’t necessarily want to go home within six hours. They do want to stay a day.”

Dr Beckett said that her own maternity unit was relatively well staffed compared with others around the country where “it is not uncommon for midwives to look after two or three women [in labour] at once”.

But it is staffed by junior doctors at night, with consultants on call. While “you can’t run the NHS with spare capacity”, she said, the ebb and flow of Bradford’s birthrate means that her team are under real pressure at times.

“Sometimes it is like a busload has arrived and we can’t predict that. Or sometimes there’s a complicated case and it takes a lot of manpower.”

While a patient with a medical reason to remain in hospital would never be discharged, she said, sometimes women benefited from a little time to adjust to motherhood before they went home. But there was not always a bed available: “To your hard-nosed money-men that doesn’t matter, but it matters to women and their families.” Maternity services, like A&E, are “Cinderella” services in an NHS driven by market forces because “you can’t manage the waiting lists”.

Dr Beckett welcomed the Healthcare Commission report because, she said: “As a society we need to have a dialogue about how we want maternity services to be. Do we want to demedicalise it and invest in home births or do we want to strengthen our hospitals? Hopefully both but that is not without financial implications.”

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