A senior NHS leader says centralizing maternity services is necessary to address staffing shortages and rising caesarean section rates, though the proposal faces significant opposition.
Key facts
- •England currently has 155 maternity units led by consultant obstetricians.
- •Caesarean section rates in England rose from 33% in 2020 to 45% in 2023.
- •The government's maternity taskforce is expected to publish a report on childbirth care before Christmas.
- •The maternity unit at North Devon district hospital has been temporarily closed since August due to understaffing.
- •An estimated 194 women have travelled to Exeter to give birth due to the closure of the North Devon unit.
Matthew Hopkins, a director at the NHS Alliance, has warned that up to 20 of England’s 155 consultant-led maternity units may need to close or change roles. Hopkins stated that centralizing childbirth services into fewer, larger hospitals is essential to ensure safety amid widespread obstetrician shortages and an increasing demand for caesarean sections. He urged ministers to support these reconfigurations despite the likelihood of political backlash and longer travel times for expectant mothers.
By the numbers
Drivers for Potential Closures
Smaller maternity units delivering between 1,500 and 2,000 babies annually are struggling to maintain safe care standards. Hopkins noted that a sharp rise in both planned and emergency caesarean sections requires more staff and operating theatres, which smaller, often rural or coastal units are currently unable to provide. Recent research from the MBRRACE-UK programme indicated that some maternal deaths between 2022 and 2024 were linked to delays in caesarean sections caused by a lack of available surgeons or operating facilities.
Opposition and Alternative Views
The proposal has met with immediate resistance from professional bodies and political figures. The Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists argued that maternity care should remain accessible near patients' homes and that alternative solutions to workforce challenges should be explored. Liberal Democrat health spokesperson Helen Morgan warned that closing rural and coastal units would leave local communities abandoned and create unsafe conditions for women in labour.
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This article was independently rewritten by ManyPress editorial AI from reporting originally published by The Guardian Health.
