Matthew Hopkins, director for acute care at the NHS Alliance, has cautioned that consolidating childbirth services into fewer hospitals is necessary to maintain safety standards. He indicated that as many as 20 of England’s 155 NHS consultant-led maternity units may require closure or role changes, particularly smaller facilities delivering 1,500 to 2,000 babies annually. Hopkins cited widespread obstetrician shortages and a significant increase in caesarean sections as key drivers of this challenge, noting that many vulnerable units are located in rural or coastal areas where staffing recruitment proves especially difficult.
The proposal has generated swift opposition from medical professionals and policymakers. Hannah Leonard, chief policy officer of the Royal College of Midwives, emphasized that women and families depend on local maternity units for accessible, high-quality care. Dr Alison Wright, president of the Royal College of Obstetricians and Gynaecologists, argued that alternative solutions to workforce challenges exist that would be safer than unit closures. Liberal Democrat health spokesperson Helen Morgan stated that forcing mothers to travel extended distances during labour poses safety risks and abandons rural and coastal communities.
The maternity service strain has already affected several locations. The maternity unit at North Devon district hospital in Barnstaple shut temporarily in August due to understaffing, with approximately 194 women giving birth in Exeter instead. The Yeovil hospital maternity unit reopened earlier this year following a nearly 12-month closure caused by insufficient staff. Separately, the Daisy Hill hospital maternity unit in Newry, Northern Ireland, was earmarked for closure last month after recruitment efforts from Ireland, the UK, and internationally failed.
Caesarean section rates have risen markedly, increasing from 33% of births in England in 2020 to 45% the previous year. Research into maternal deaths between 2022 and 2024 identified cases where caesarean sections were delayed or postponed due to unavailable obstetric surgeons or operating theatres. Hopkins stressed that further increases to 55% or 65% would inevitably force reactive measures and emphasized the importance of strategic planning before the government’s maternity taskforce releases its report on improving childbirth care.
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