Up to 20 maternity units could close in England — The Guardian

Up to 20 National Health Service maternity units in England could close or change their role due to a shortage of doctors and the growing number of caesarean sections. The Guardian reports, citing Matthew Hopkins, director of acute care at the NHS Alliance.

Centralisation of maternity care

According to Hopkins, up to 20 of England’s 155 consultant-led maternity units could cease operating or change their format. He said that concentrating maternity care in fewer hospitals was inevitable in order to provide safer and more sustainable care for mothers and newborns.

He considers small units that handle between 1,500 and 2,000 births annually to be the most vulnerable. Such facilities face a shortage of obstetricians and gynaecologists, while the prevalence of caesarean sections requires more staff and operating theatres. Many units that could face closure are located in rural or coastal areas, where it is particularly difficult to recruit medical staff.

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Objections from medical organisations

Hannah Leonard, chief policy officer at the Royal College of Midwives, said that women and families rely on local maternity units, so high-quality care must be available close to home. Alison Wright, president of the Royal College of Obstetricians and Gynaecologists, said that other ways of addressing staffing problems should be considered before units are closed.

The maternity unit at North Devon District Hospital in Barnstaple was temporarily closed in August due to staff shortages. Royal Devon University Healthcare Trust was to decide whether there were enough doctors there to safely resume operations. It was estimated that because of the closure, 194 women gave birth in Exeter, located 43 miles from Barnstaple; the journey takes about 70 minutes by car.

Rising share of caesarean sections

Professor Marian Knight of the University of Oxford had also previously called for the consolidation of maternity units to be considered. According to the data cited, the share of caesarean sections in England rose from 33% of births in 2020 to 45% last year. The MBRRACE-UK report noted that some women who died during childbirth in 2022–2024 faced delays or postponement of a caesarean section because an obstetric surgeon or a free operating theatre was unavailable.