By Caroline Flint

Caroline Flint reports on the impending threat to the personalized midwifery care service in Hampshire

In a sleepy corner of Hampshire women are up in arms, fighting for the maternity service which they have had for the past 20 years and taken for granted.

Women in Fairoak and Bishopstoke, near Winchester, had never realized that their maternity care was different from other women's - they just knew they liked it and enjoyed getting to know their two midwives, Jan Barnes and Sylvia Coles, who gave them antenatal care during their pregnancies.

When they went into labour they just telephoned whichever of the pair was on at the time.

After that either Jan or Sylvia came and looked after them in labour - either in their own home or, when the time was right, they all set off for the local general practitioner unit.

After the birth the two midwives visited the women daily to help a new mother to bath her new baby and change the nappy, or to discuss with experienced mothers good ways to incorporate the new baby into an existing family with as little jealousy as possible.

The women of Fairoaks and Bishopstoke have what they have been requesting for years - real continuity of care, where a familiar and trusted midwife provides care all the way through pregnancy, childbirth and the postnatal period. But now this excellent service is under threat.

The first blow came last October when the midwives were told that they were no longer allowed to claim for their overtime but in future would have to take time back `in lieu'.

Soon another blow was to fall - they were told that in future they must not go out when not officially `on call' and were threatened that if they did they would not be covered by the health authority's insurance protection.

Cathy McCormick, Royal College of Midwives' Senior Labour Relations Officer, is tackling this issue on two counts - first the disregard of 20 years of custom and practice, and second that legally employers cannot abrogate responsibility for the actions of their employees. Midwives, therefore, should always be covered by the health authority.

The midwives are also receiving support from a vocal group of local mums. Mandy Shedden, a mother of three, explained that the two midwives had given excellent and compassionate care over the years which women appreciated. But the health authority was suggesting that in future when a midwife is called to a woman in labour it has to be the midwife on call for the whole of the large area of Eastleigh - and that could be any one of eleven midwives unlikely to know the mother.

Mandy Shedden points out that as many of the other midwives come from miles away, they do not know the geography of the local area and may have problems finding the house. The other worry for the mothers is that many of the other midwives have not done a home birth for years out of preference.

The Capital Development Manager at the Royal Hampshire County Hospital Idwal Weale, said that although the midwives were working in line with `patient demand', it was not in line with health authority policy which was to rationalize and streamline the provision of maternity care.

Senior midwife Ruth Nixon said that in Winchester they were not going for the principle of `continuity of a known face' but for `continuity of advice'.

The mothers are suspicious that the excellence of the care provided by their two local midwives is showing up the inadequacies of the rest of the service.

They have been told that the service can remain for a three month period while discussions take place. But they are worried that this is just a delaying tactic and that in three months' time a valuable service may have gone for ever.