The government is being warned of a crisis in maternity care as midwives work extra hours to ensure services are safe.
The Royal College of Midwives (RCM) said pay was driving staff out of the profession and fuelling industrial action.
A survey of senior midwives showed they are relying “significantly” on the goodwill of staff working extra hours, often unpaid, said the RCM.
The survey among scores of directors and heads of midwifery (DoM/HoM) paints a stark picture of “chronic workforce shortages” said the report.
The report said: “The loss of experienced midwives is also impacting on the ability to support and train student midwives on their placements in the NHS.
“They are leaving because they cannot deliver the quality of care they so desperately want to want, because of their falling pay, and because they are exhausted, fragile and burnt out.”
Dr Suzanne Tyler, RCM executive director, said: “Our worst fears about where we saw maternity services heading are becoming a reality and the fault lies squarely at the door of successive Conservative governments.
“Chronic understaffing is hitting the morale of midwives and maternity support workers (MSW) and the safety of care.
“They are leaving in droves and the Government must plug this worrying leak as a matter of real urgency.
“Improving pay, more investment and increasing the workforce are crucial to building back our shattered maternity services.
“The Government must do that now and it can start with giving maternity staff the inflation-busting pay award they deserve.”
If the midwifery workforce had grown at the same rate as the NHS workforce as a whole over the last decade, there would be 5,000 more midwives and no midwife shortage, said the RCM.
Nearly three out of every four HoMs and DoMs said they were finding it either difficult or very difficult to recruit to vacancies in their units and four in five admitted it was difficult to ensure staff take their breaks and leave work on time.
Midwives in Wales are to stage an eight-hour strike on February 7 on the same day that thousands of nurses are also due to go on strike.