NHS bosses say smaller maternity units may have to close

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   NHS bosses say smaller maternity units may have to close

   BBC NewsPublished Oct 19, 2026Checked Oct 20, 2026

   “NHS bosses in England say the way maternity care is organised is "not fit for purpose" with safety at risk, and warn up to 20 smaller units may have to close. The NHS Alliance, which represents health managers, says difficult decisions lie ahead and maternity services need to be consolidated to support safer care. It said a government taskforce into neonatal and maternity care must tackle key issues such as a lack of specialist staff and a rise in C-sections. The Department of Health and Social Care said every woman deserves safe maternity care, and the taskforce "will deliver the reforms needed to ensure services meet the needs of women and families now and in the future". The NHS Alliance said there are particular pressures on smaller units in rural and coastal areas and that those delivering 1,500 to 2,000 babies each year might need to close. The organisation said up to 20 out of 155 consultant-led maternity units in England face closure. It says staffing problems and rising numbers of C-sections are making smaller units potentially unsafe. The rise in C-sections was a challenge, according to the NHS Alliance, and there were inadequate operating theatres and beds in outdated and decaying buildings, posing a safety risk. The NHS leaders' organisation also said some smaller units struggled to maintain safe staffing numbers for 24-hour care, including midwives and consultants such as obstetricians.”

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   SMFM Special Statement: Opportunities to improve access to maternal-fetal medicine care in rural and underserved communities.

   Pregnancy (Hoboken, N.J.) (Society et al.)Published Feb 4, 2026Checked Oct 20, 2026

   “Access to obstetrical and subspecialty maternal-fetal medicine care has continued to decrease in recent years, with a notable obstetrical workforce shortage. Maternity care deserts subsequently lead to worsening perinatal outcomes in these regions. High-risk pregnancies require a higher level of obstetrical care, which is becoming increasingly less accessible. Accessibility is inversely related to adverse perinatal outcomes. This Statement summarizes the health effects of increasing maternity care deserts and geographic disparities, as well as existing programs and initiatives focused on bolstering the healthcare workforce. It also includes specific policy recommendations to improve adverse perinatal outcomes related to the current workforce shortage. Federal medical training programs, programs incentivizing practice in rural and underserved areas, telehealth expansion, and federal and state programs focused on improving maternity care deserts offer solutions to improve the current state of perinatal outcomes; however, it is imperative to increase the maternal-fetal medicine workforce in underserved and rural areas and increase access to subspecialty obstetrical care.”

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   'I pack two birth bags': women's accounts of preparing for hospital or roadside birth during maternity unit closures in rural northern Sweden.

   BMC health services research (Morian et al.)Published Jun 30, 2026Checked Oct 20, 2026

   “Three interpretative repertoires were identified: equity and legitimacy, where women framed rural living as a chosen life yet treated secure maternity care as non-negotiable; moral responsibility, where risk management shifted from system-level preparedness to women's own planning, including preparing for both hospital and roadside birth; and bodily vulnerability and dignity, where distance, admission thresholds and travel reshaped bodily labour, dignity and help-seeking, sometimes leading women to delay or avoid contacting healthcare services despite their concerns.ConclusionIntermittent closures disrupt access to maternity care and shift the responsibility for managing uncertainty and risk from the healthcare system to women themselves. Access to sexual and reproductive health services is more than a matter of geographical availability; it is shaped by how responsibility and legitimacy are negotiated in practice. Maternity services function as a clinical service and as a condition for whether family life feels possible and sustainable in rural communities.”

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   Reducing Rates of Cesarean Delivery in Rural US Communities: A Systematic Review of Interventions and Approaches to Care.

   Preventing chronic disease (Funakoshi et al.)Published Jul 30, 2026Checked Oct 20, 2026

   “None were categorized at the provider level. Seven interventions tested system-level models, primarily comparing hospitals with different staffing patterns; family medicine-led hospitals had lower rates of low-risk nulliparous, term, singleton, vertex cesarean delivery than hospitals staffed by both family medicine physicians and obstetricians (23% vs 28%), certified nurse-midwife-managed births had lower cesarean delivery rates than family medicine physician-managed births (8% vs 14%), and collaborative maternity care models integrating midwives, nurses, and obstetricians were associated with cesarean delivery rates declining from 26.2% to 11.2%.ConclusionSystem-level approaches, particularly those that restructure maternity care teams, emphasize family medicine physician-led models, and integrate midwifery and culturally grounded childbirth practices, are more consistently associated with lower cesarean delivery rates in rural US settings than patient-level interventions alone. Future efforts to reduce unnecessary cesarean deliveries should prioritize strategies tailored to the variability of rural care capacity.”

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   Perceptions of maternity care-seeking and care-giving experiences during a health-system shock: a qualitative study with healthcare professionals and policymakers in the UK, with a focus on care for marginalised groups.

   BMJ public health (Rowell et al.)Published Jun 11, 2026Checked Oct 20, 2026

   “The standardisation of self-monitoring and virtual care, although beneficial for some, adversely affected those with medical and social complexity. Policy had failed to address inequalities prior to service reconfiguration, making it harder for HCPs to engage with marginalised groups. This included service users with social complexity: lack of social support, mental health problems or belonging to a minority group relating to sexual orientation or gender identity; or medical complexity: those who had to perform self-monitoring of symptoms during pregnancy for any complication, including hypertension, gestational diabetes, additional scans for predisposition to genetic complications, or previous pregnancy loss. A lack of ethnic diversity within leadership roles meant guidelines failed to consider the needs of minority groups who subsequently received substandard maternity care.ConclusionsThis study affirms the negative effects the pandemic had on maternity care-seeking and experience, while highlighting the need for policy to prioritise marginalised groups, patient-centredness and the well-being of HCPs and policymakers to rebuild a resilient maternity service.”