Temporary suspension of Home Births: Frequently Asked Questions

Home Birth Suspension – Frequently Asked Questions

These Frequently Asked Questions (FAQs) have been created from the questions and comments we've received from the public and our staff regarding the suspension of our home birth service for two weeks. We really do appreciate you sharing your experience, insights and ideas with us, this helps us to ensure all voices are being heard and considered during our review. We hope this provides you with the information you need from us to understand the situation at this time and supports you to continue to help us through the review and improvement of our services.

1. Why has the home birth service been suspended?

The Trust has temporarily paused home births due to safety concerns raised by staff. It is important that we listen to our staff and ensure that the service is safe to provide births in the home. We have immediately suspended the home birth service to allow us the time to fully understand and appropriately act on these concerns. There are 3 main reasons for this:

• Staffing: Although we are now fully recruited in our midwifery numbers, our new recruits are predominately newly qualified midwives who cannot support community services yet and the community team midwives who have limited recent labour care or home birth experience.
• Home births are considered safe for low-risk pregnancies, safe care can only be provided by midwives who have the experience and training to support a home birth. If complications arise, it could become unsafe for the woman or birthing person and their baby.
• There has been an increase in the number of requests to support births at home against medical advice or for women and birthing people with additional risk factors. Due to the increase in the number of requests to support births at home against medical advice, we need to review our current guidelines, standards and processes to fully inform and support the choices and preferences of women and birthing people requesting to birth outside of guidance.

2. Why now?

Our service has been working on improvements across our whole maternity service. We have had a specialist improvement advisor supporting us with several projects in the last few months, and community services has been one of these. Whilst reviewing the community service, we have identified areas that need to be fully reviewed and changed to ensure high-quality community care is being provided safely and equitably across Gloucestershire.

3. Can I still choose to give birth at home?

Yes, you have the right to choose your place of birth. However, during the suspension period, we will not be able to provide you with midwives to attend your home birth. We very much want to support you to make an informed decision about your place of birth and the options available to you and will do whatever we can to support you to have the information you need to make the best choice for you. We are happy to offer further consultations and birth planning with the midwifery team and/or wider multi-disciplinary team including face-to-face appointments if that is helpful.

4. Is home birth safe?

For low-risk pregnancies, home birth is considered safe and is supported by national clinical guidelines (NICE). However, safety also depends on having midwives with the right level of experience to support you and your baby.

Complications during birth can happen even with a low-risk pregnancy. Midwives attending a home birth need to be able to work with autonomy and recognise complications quickly to ensure a transfer can be made to clinically support the care that is needed.

Without a midwife skilled in labour care at home the risks could increase. Planned home births against medical advice are considered unsafe and are not recommended.

Choosing to have a home birth against medical advice (or outside of guidance as this can also be known as) should be carefully considered only after you have been given all the clinical information for your individual circumstances, including the potential risks to you and your baby if you choose to birth at home.

5. What are your rights?

You have the legal right to choose where you give birth. The NHS has a duty to provide services that are safe. If they cannot safely staff a home birth, they are not obligated to provide that service during the suspension. We have temporary suspended the homebirth service due to safety concerns and staffing capacity, we are doing everything we can to ensure the home birth service is available as soon as possible.

You can find out more about your rights at Birthrights - your human rights during pregnancy and maternity care

6. Can the Trust hire independent midwives to cover the gap?

The Trust is reviewing all options, contracting independent midwives involves complex legal, financial, and insurance considerations. We are also reviewing our home birth guidelines and processes and will be learning from other areas that have gone through this process. Independent midwives need to work within our guidelines and governance processes so it is vital that these are all in place to ensure the service is safe. Hiring extra staff or independent midwives is not going to immediately solve the problem.

7. What if I go into labour quickly and can’t get to the hospital?

You should call our maternity triage telephone number as soon as you think you are in labour for advice and come into the hospital as soon as possible if things are happening quickly. However, in an emergency, you should call 999.

8. Is this decision linked to a recent incident?

No, this decision has been made to prevent a serious incident occurring.

9. Why is there a shortage of midwives for home births?

Over the past two years, we have been able to recruit more midwives to our service, and we now have the equivalent of 245 midwives working for the Trust. We have been pleased to welcome many newly qualified midwives who are essential to support the future of maternity services, but less experienced midwives are not able to attend home births. We have not yet been able to staff a dedicated home birth team, which requires midwives with significant skills and experience because of the degree of autonomy they require to support and care for you at home during labour.

Although home births account for less than 2% of births (around 4 home births per month) in Gloucestershire, we are finding it hard to cover the on-call home birth service from our community teams at night without risking staff working after a full day shift, which could be unsafe. Between May and September 2025, we have only been able to cover the 24-hour home birth rota 50% of the time. These gaps are mainly outside of 9-5 when most babies are born.

10. What are my options?

Our midwives and maternity support workers will continue to provide the same level of midwife led care and support at Gloucestershire Royal Hospital and Stroud Maternity Hospital. Our birth centres offer midwife led care in a home-like environment. You can also bring things into the birth centre or hospital to personalise your birth space, such as music, lighting, and anything that makes the space more comfortable. We want to support you as best as we can with your choices, your community midwife can answer any questions and make a personalised birth plan with you.

11. What if I am considered high risk?

If your pregnancy is considered high risk, it is recommended that you have your baby in a hospital with obstetric doctors and neonatologists.

12. What is the plan to reinstate the full home birth service?

We will update you very soon with the plans to reinstate the service. This will involve a full review of our community staffing and delivery of all midwife led community births and locations, as well as a full risk assessment, including quality and equality impact assessments. It is likely that a longer-term suspension of the service will be necessary to allow us to complete this.

Any new model of care will be co-designed with staff, women and the local community, including doulas.

13. How can I raise concerns or get more information?

If you are currently under our care, you can speak to your community midwife.

You can also contact the Trust directly via our Patient Advice and Liaison Service (PALS) team who are here to support our patients, relatives and colleagues by discussing their experiences and helping to resolve concerns.

• Call: PALS - 0800 019 3282 (If we cannot answer your call, please leave a message and we will call you back as soon as we can).
• Email: ghn-tr.pals.gloshospitals@nhs.net
• Write: PALS Office Gloucestershire Royal Hospital Great Western Road Gloucester GL1 3NN

We will be working closely with our Maternity and Neonatal Voices Partnership (MNVP) during this time to ensure we keep the voices of our community in our reviewing and planning of the service. You can share your feedback anonymously and find out more about our MNVP here Gloucestershire Maternity and Neonatal Voices

14. Has the Home Birth been suspended previously?

Yes. Home births were suspended in many UK areas during the COVID-19 pandemic, and this was on regular review. In December 2022 there was a temporary suspension due to significant across the county and again in January 2023 due to staffing levels.