Midwives from overseas are being recruited to help Bedfordshire Hospital NHS Foundation Trust fill its vacancies in the face of a national shortage.
A report said the Care Quality Commission (CQC) visit to Bedford Hospital's maternity department in November 2020 identified concerns with staffing levels for midwives and doctors.
It felt this shortage impacted negatively on staff morale and the ability to complete training.
But, it added, the CQC did not see any evidence of this impacting negatively on the safety of the women or their babies.
The report, which was presented to a Bedford Borough Council committee last night (Monday, January 17), said that the CQC's return visit in June 2021 found that there was still a shortage of midwives.
Emma Hardwick, director of midwifery at Bedfordshire Hospital NHS Foundation Trust, told an informal meeting of the council's Health Overview & Scrutiny Committee that registered midwives are "very hard to come by" and there is a "very significant" national shortage of midwives.
"We have had a number of newly-qualified and experienced midwives join us, not perhaps as many as we had hoped for, but we have had a relatively large number in relation to our workforce," she said.
"We have also participated in the recruitment of international midwives.
"By the end of March, we will have four international midwives commencing in the Trust, which doesn't sound like very many, but we're really excited about that."
The committee's chair, councillor Graeme Coombes (Conservative, Wilshamstead Ward) said: "I presume that there would be an internationally recognised minimum midwifery qualification, which all of these people would have to have before they started work."
Ms Hardwick said: "We have quite a rigorous recruitment process, both for ourselves, but also to make sure that it is in line with the Nursing and Midwifery Council's recommendations.
"They need to be ethically sourced, and there are, of course, many requirements that they need to meet before we can even interview them.
"Once they actually come to the UK and start with us, we prepare them for a recognised face-to-face assessment that's held in one of the UK's assessment centres.
"It takes us about four or five weeks to prepare them for that face-to-face test," she added.
"Once they have passed that assessment, along with the qualifications they have from their own country where they qualified as midwives, and often as nurses as well, they then undertake a personalised programme to embed them into our workforce."
Councillor Hilde Hendrickx (LibDems, Newnham Ward) pointed out that the Trust didn't appear to have any issues when recruiting senior members of staff.
"Is there anything about the conditions you offer that perhaps could be improved for, let's call them normal midwives or recently qualified midwives, both in terms of pay or any additional roles they could take on," she asked.
Ms Hardwick replied: "I think it's remembering that there are less of those [senior] posts than there are of the other posts.
"For some of those posts it has taken a little while to recruit into them,
"Demand is outstripping supply for our band five, six and seven clinical midwives. There are just far more posts than there are midwives to recruit into them.
"We recruit as part of NHS under Agenda for Changes, and we do provide a competitive rate for our newly qualified midwives coming in.
"And we have competitive rates for bank pay, but we do recruit under our agenda for change."
Councillor Dean Crofts (LibDems, Kingsbrook Ward) asked if the next report could include how many maternity midwives the hospital actually needs and where it is in relation to that target.