Community Birth Team: Your questions answered

What is changing?

We are proposing a new countywide Community Birth Team, available 24/7, to support community births across Gloucestershire. The change is mainly about how we organise our staffing, helping us to have the right staff available in the right places to provide safe and sustainable care.

What would the Community Birth Team do?

The Community Birth Team would provide care for women choosing community birth across Gloucestershire, including births at Stroud, Cheltenham and at home. A dedicated team will help midwives maintain regular experience of community birth while allowing the service to respond flexibly to demand across the county.

Why a countywide team rather than locality-based teams?

Locality-based approaches were considered but we concluded uneven geographical demand could lead to unequal workloads and insufficient exposure to intrapartum care in lower-demand areas. A countywide team provides cross-cover, resilience and flexibility.

Are community maternity services being reduced?

No. The proposal aims to broaden access to community birth across Gloucestershire, rather than reduce the services available.

It would support births at Stroud, restore birth care in Cheltenham and enable us to restart the currently suspended home birth service.

Will specialist community birth skills be restricted to the new team?

There is no intention to restrict training and development to the dedicated team. Other community midwives could potentially contribute to community births as the model develops, subject to appropriate competence, preparation and governance.

Is this a continuity-of-carer model?

The model is not proposed as a full continuity-of-carer model. Its primary purpose is sustainable community intrapartum care. However, reduced caseloads should give midwives greater opportunities to build relationships with women and families.

Why are you making these changes?

We want women and families across Gloucestershire to have more equitable access to community birth.

The proposed model takes account of where services are needed, our available workforce and previous experience of providing community birth care across the county. It has also been informed by work to reduce inequalities in access to maternity care

What does this mean for Stroud Maternity Unit?

Stroud will remain an important part of our community maternity services and women will still be able to give birth there.

The proposed change is that Stroud Maternity Unit would no longer have staff permanently based there 24 hours a day. Women will still be able to give birth at Stroud at any time 24 hours a day, 7 days a week, with the Community Birth Team attending to provide care when it is needed. Before the new arrangements begin, women will receive clear information about how to contact the team and access the unit.

Community midwifery and other community maternity services will continue to be provided from Stroud. There will also be increased access to local antenatal clinics and scanning services

Why won't Stroud Maternity Unit be staffed 24/7?

The consultation considered this feedback carefully. Current levels of demand and the available workforce do not support having staff permanently based at Stroud 24 hours a day.

A countywide team allows staff to support women wherever community births are taking place, including Stroud, Cheltenham and women's homes.

Women will be given clear information about how to access the service and expected response times. Comparable models operate successfully in neighbouring trusts.

Will home births be available again?

Yes. The proposed model is designed to allow us to restore our currently suspended home birth service and provide a more sustainable way of supporting home births across Gloucestershire.

What is proposed for Cheltenham?

The proposal aims to restore community birth care in Cheltenham as part of the wider countywide offer.

How will one team cover the whole of Gloucestershire?

We know Gloucestershire is a large and rural county, and travel and response times were among the concerns raised by staff during consultation.

Having one countywide team provides flexibility to respond to where births are taking place and allows staff to support each other when there are simultaneous births or other pressures.

Once the team is established and we better understand demand across the county, we will continue to review how the service is organised to support local responsiveness.

How will you make sure the service is safe?

Safety is central to the development of the new model.

Quality and Equality Impact Assessments have been undertaken, and senior maternity leaders will closely monitor staffing, activity and workforce capacity as the model is introduced.

The service will be regularly reviewed to make sure it remains safe, sustainable and responsive to women, families and staff.

What happens if several women need the service at the same time?

The countywide approach is designed to provide greater flexibility and resilience, allowing staff to respond to demand across Gloucestershire.

The model is designed to support two simultaneous births. Clear escalation arrangements will manage demand beyond this capacity and support timely transfer to obstetric care where required. Staffing, activity and outcomes will be monitored through maternity governance to ensure the service remains safe and resilient.

What did staff say during the consultation?

Eight consultation responses and one request for further information were received. Feedback showed broad support for restoring home births, strengthening community maternity care and improving access to physiological birth across Gloucestershire.

Staff also raised important concerns, including travel across and the size of the county, staffing and working arrangements, continuity of care and how the service would manage periods of increased demand and whether locality-based teams might provide an alternative approach.

We have carefully considered this feedback and thank everyone who took part for sharing their views and professional expertise.

Has staff feedback changed the proposals?

All responses were considered individually and the issues raised have informed the review of the model. Following consideration of the feedback, the preferred option remains a centralised Community Birth Team.

The service has also identified areas that can continue to be considered as the model develops, including how birth availability might be organised geographically and whether other community midwives could contribute to community birth activity in future, subject to appropriate training, competence and governance arrangements.

What happens next?

Following consideration of the consultation feedback, the preferred option of a centralised Community Birth Team is now being taken forward.

We will continue to work with staff as the model develops and regularly review the service to ensure it remains safe, sustainable and responsive to the needs of women and families across Gloucestershire

Were women's and families' views considered?

Our community has told us that community birth options, including home birth, are important to them and that they want these services restored safely and sustainably as soon as possible. This feedback has helped shape the Community Birth Team model, alongside work undertaken since June 2025 and the NHS Gloucestershire Integrated Health Needs Assessment 2026/27. Together, this evidence has informed how we target resources towards areas of greatest need and reduce inequalities in access to maternity care.

The proposed changes required a staff consultation because the work we’ve been doing on the proposed Community Birth Team model changes how we organise our staffing so that we have the right staff in the right place at the right time to deliver those services safely and effectively, restore homebirths and reopen Cheltenham. There is no change to how women and families access the maternity services we provide.

Does the new model address the concerns that led to the suspension of the homebirth service?

Yes. The new model has been designed in response to the concerns that contributed to the suspension of the home birth service, including workforce vacancies, the experience of the community midwifery workforce, staff wellbeing, lone working, fatigue, support at home births, senior oversight and care outside local guidance. The team will use planned birth availability shifts rather than traditional on-call arrangements. Learning from the previous service has informed the approach, particularly the arrangements for rest, staff support and senior oversight.

Does the model provide genuine choice?

The way we provided our home birth service previously was not working for all our population and it wasn’t working for midwives. Under any model, there is a possibility choices may be unavailable because of staffing pressures but we are confident the Community Birth Team model will provide a safer and more consistent service offering genuine choice between home, community and hospital birth. It is flexible and easier to expand as demand grows.

When will homebirths be available?

We do not yet have a confirmed date for restarting the home birth service or reopening Cheltenham Birth Centre. Before these services can resume, we must be confident that the right staffing, training, facilities and safety measures are in place to provide safe, high-quality care.

In the meantime, if you are interested in having a home birth, please speak to your midwife about the options available to you. They will be able to discuss your individual circumstances and help you make an informed choice about your care.