Baby boom
We are in the middle of a baby boom. Just over 690,000 little ones popped out in England and Wales last year - 20,000 more than the year before and the highest number since 1991.
But this explosion of fecundity is different from previous booms, as new figures from the (pdf link).
Compared with a decade earlier, British-born mums had 64,000 fewer babies last year. However, foreign-born mums had 64,000 more babies over the same period.
It is immigration which is pushing up the birth-rate in this country with almost a quarter (23%) of all the babies now delivered to foreign-born mothers - the highest ever proportion. In parts of London the figure rises to 74%.
Reading today's (pdf link) on maternity services in England, I was surprised that so little was made of the impact immigration is having.
The authors reveal how some women giving birth are being admitted to units that do not have enough beds, showers or toilets. Consultants do not always spend enough time on the wards, not all staff receive adequate training and choice of where to give birth could be limited.
But what the Commission does not do is explain that these pressure points are very often in areas which have seen a jump in the birth rate locally because of a growing migrant population.
Where are the shortages of mid-wives? Chiefly in London and the South East, the areas which have experienced the most rapid changes in birth rate due to inward migration. It is here, too, that many maternity units have had to close temporarily because of unexpected demand.
For instance, in Slough where every other baby is now delivered to a mum born overseas, there have been hundreds of extra babies a year which doctors had not been expecting.
Last summer the local health trust was forced to take drastic action. The maternity unit in Ascot was shut for two months so they could move midwives to the Slough centre. The hospital explained the closure was due to an unprecedented 9% increase in the birth rate.
In terms of the experience of mothers, the three areas which scored worst are in parts of London with some of the highest proportions of foreign-born mothers.
In an appendix at the back of today's Healthcare Commission report the authors do say this:
"Overall, women from black and minority ethnic groups were more likely to access services late and less likely to have a scan at 20 weeks than women from the White British group. They were more likely to experience complications such as needing a hospital stay during pregnancy, having a longer stay in hospital after birth, and having their baby cared for in a neonatal unit. They responded more negatively to questions about care during labour and birth, and were less likely to say they had a choice about the place of birth."
Are we letting this vulnerable group of mothers down?
Philip Steer, editor of the British Journal of Obstetrics and Gynaecology and senior consultant at Chelsea and Westminster Hospital, certainly thinks so.
"The major cause of maternal death is now heart disease", he tells me. "The incidence of heart disease causing maternal death has approximately trebled in the last 15 years and the great majority of those are occurring in women arriving in the country from overseas."
He also points out that almost one in 6 of mothers who died in the last three years had poor English.
The inquiry into the deaths of ten mothers at Northwick Park Hospital in North West London in 2006 also highlighted poor communication as a (pdf link). Only one of the ten women who died was from a European background.
I fear some readers will see this post as some kind of attack on immigrants or immigration - blaming foreigners for putting a strain on maternity services. My intention is quite the opposite. I no more "blame" mothers from overseas for the pressure on midwives than I blame the elderly for putting pressure on social care.
But as Professor Steer put it to me: "If we're encouraging these people to come to the UK then we have an ethical duty to provide a proper standard of care."
I'm 
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