Open Letter, Impact Statements & Over 160 Signatures
Sent Monday 17th November 2025
Dear Kevin McNamara, the interim leadership team, and the regional maternity leadership,
The BBC has now reported that Gloucestershire’s two-week suspension of home birth services is “likely to be extended”. From everything we see on the ground, this is not a pause. It is an open-ended shutdown that removes a safe, evidence-backed option for most women and leaves entire communities without accessible maternity care.
We have contacted the Trust repeatedly asking for transparency, AEQUIP assessments, staffing analysis, and contingency planning. We have not received a reply.
That silence is now becoming a safety risk in itself.
Home birth is not the danger. Centralised obstetric care is.
Across the UK, Europe and Australia, decades of research show a consistent pattern:
For most women, giving birth at home or in a midwifery-led unit leads to fewer injuries, fewer complications, fewer major interventions and less trauma than birthing on a consultant-led obstetric unit.
This is because environment, continuity, and the quality of support matter far more than the labels used in hospital risk classifications.
Obstetric units consistently carry higher rates of:
postpartum haemorrhage
severe tearing
episiotomy
instrumental birth
unnecessary caesarean section
obstetric violence and psychological trauma
This is documented in the Birthplace Study, the Cochrane review of midwife-led care, the Dutch national cohort data, and the Australian multi-jurisdiction studies.
The current policy forces women into an environment where the known, recorded risks are higher. It is not “safety first” to remove the safer option.
This is not only a staffing crisis. It is a leadership crisis.
The BBC has now confirmed what many midwives have been telling me privately:
experienced midwives are leaving
senior leaders are stepping down
newly-qualified midwives are being left without adequate support
fourteen experienced midwives have left in six months
This is not simply a workforce number issue. It is a retention crisis caused by culture, centralisation, lack of professional autonomy, and the erosion of community midwifery.
The quiet departure of the Director of Midwifery after four years speaks volumes about the conditions inside the service.There are contingency options. Other Trusts use them. You are choosing not to.
Trusts around the UK stabilise maternity services by:
contracting Independent Midwivesthrough lawful frameworks
partnering with Zest Midwives, whose practitioners have specialist training, safeguarding compliance and full insurance
using Zest MaMas (Maternity Assistants) as trained, skilled, supervised birth attendants
restoring continuity-of-carer teams
decentralising services to community settings
reopening or partially reopening birth centres
Gloucestershire is using none of these options—at least, none that have been publicly disclosed.
RCM’s own position supports extending the midwifery team
The Royal College of Midwives has repeatedly acknowledged that:
Maternity Support Workers can safely expand what midwives can offer
Skill mix, when done well, increases safety
Experienced birth companions improve continuity and reduce trauma
This aligns directly with the Zest MaMa model: trained companions who are safeguarding-certified, clinically supervised, prepared for community birth, and embedded in a larger model of midwifery support.
They are trained, supervised, safe, insured, and capable support staff—exactly what overstretched services need.
Doulas and birthkeepers: an expertise you continue to ignore
Local doulas, birthkeepers and independent midwives:
bring thousands of cumulative hours of experience
provide continuity your system cannot replicate
reduce interventions
reduce trauma
stabilise home births when NHS staff arrive late
protect physiological birth
support breastfeeding
bridge communication between families and the Trust
You are excluding the very people who are already keeping women safer in an overstretched system.
Where is the £130 million for maternity safety being spent?
The Government has announced £130m of investment to improve maternity and neonatal safety.
Yet in Gloucestershire:
the Forest of Dean has no birth facility at all
Aveta Birth Centre in Cheltenham remains closed after four years
home birth is suspended
continuity teams are dismantled
midwives are leaving in numbers
the Director of Midwifery has resigned
families find out changes from BBC News—not from the Trust
no contingency plan has been shared
We are entitled to know how much of this funding has reached Gloucestershire and how it has been used.
Where is the investment?
Where is the improvement?
Where is the transparency?
Inequality is widening
Removing community birth options erodes safety for disadvantaged families.
The evidence is clear:
Continuity and community midwifery significantly improve outcomes for families in deprived areas.
Breastfeeding—supported best by continuity models—is one of the strongest equalising factors in long-term health and educational outcomes.
Home birth and community support prevent avoidable hospital admissions and reduce costs.
By stripping community options from rural and lower-income areas, the Trust is widening inequality, not reducing it.
Midwives are not the problem. The system is.
Midwives are leaving because:
their judgement is overridden
their expertise is ignored
the culture is unsafe
the workload is unmanageable
their ability to practise true midwifery has been taken away
This is not burnout.
It is a rational response to an unworkable environment.
Recruiting more juniors will not fix this.
Where is the co-production?
We were told details were been passed to the new MNVP lead.
We have had no contact.
We were told “listening events” shaped service decisions.
There is no evidence that they did.
We have asked clearly for transparency.
There has been no reply.
Co-production is not a slogan.
It is a process, and it is missing.
Yours sincerely
Community of Women, Doula's, Midwives, Families & Community Members
Impact Statements
“After a traumatic first birth in hospital and a wonderful second birth at home, I am devastated at the thought of women now being forced back into the system I found so unsafe. With home birth suspended, we are being pushed into making impossible choices and being forced to consider freebirth as our most likely option.”
“I am directly impacted by home birth suspension. I am terrified of not reaching hospital in time from a rural community (45 mins from hospital).”
“I am pregnant and this situation is causing a lot of stress to a lot of women.”
“If the current situation is not improved and there is little possibility of home birth, I will be reconsidering my options. It is such a shame as my experience of the midwives there was very positive.”
“I have experienced both delivery suite and birthing suite care and the difference was enormous. The impact on my body after birthing suite (non-obs) care was like night and day.”
“We had a home birth planned for January because my wife’s first birth was traumatic in hospital, but that option has now been taken away from us.”
“I won’t be having more children now but I home-birthed my daughter and this is a matter very close to my heart.”
“I feel unsafe and unsupported. I feel like women's needs have been ignored once again.”
“My first labour was extremely traumatic and I planned a home birth to avoid this again. I feel lost.”
“I am a first-time mum who chose home birth for safety reasons, and now I feel that has been taken from me.”
“I live rurally, and it takes nearly an hour to reach the hospital. I am terrified of giving birth on the side of the road.”
“My second baby was born in water at home and it was the safest and most peaceful experience. I can’t believe other women are being denied this.”
“I have cancelled plans for more children because I cannot go through the hospital system again.”
“As a birthworker, I see firsthand how frightened women are. The anxiety is huge.”
“I suffered obstetric violence during my hospital birth and home birth was my only way of feeling safe.”
“This decision has put massive pressure on families who were already struggling.”
“I had a traumatic tear and haemorrhage with my first birth because of unnecessary interventions.”
“This has affected my mental health more than I expected.”
“We planned a home birth because of previous trauma — now I don’t know what we’re going to do.”
“My partner is disabled and cannot drive. Without home birth as an option, the logistics feel impossible.”
“I am heartbroken. I waited years to try again after trauma.”
“I wanted a home birth to protect my baby from unnecessary interventions.”
“I cannot afford a doula or private midwife. I feel abandoned.”
“We have no family nearby. Taking away home birth means risking labour alone while arranging childcare.”
“I am terrified of induction pressure.”
“I am already 39 weeks and have nobody to even discuss this with.”
“I do not consent to being forced into hospital.”
“This has caused sleepless nights.”
“My last baby came very fast. I am scared the ambulance won’t reach us in time.”
“This decision feels like punishment for wanting physiological birth.”
“I’m still recovering emotionally from my first experience and now have no safe option.”
“Removing home birth doesn’t increase safety. It removes it.”
“Continuity kept me safe last time. Now it doesn’t exist.”
“I chose home birth because I live with PTSD.”
“I don’t want to give birth surrounded by strangers.”
“Birth shouldn’t feel like a threat.”
“The system is breaking women. This suspension is the last straw.”
“I do not feel safe birthing in a consultant-led unit.”
“My doula has already warned me about the risks of trauma in hospital.”
“I had a previous postpartum haemorrhage caused by hospital protocols.”
“I had a home birth before and it was the best experience of my life.”
“I trusted the midwives completely — now I don’t know who will even attend me.”
“I feel like I’m being forced into harm.”
“I don’t drive. If my partner is at work, I have no way to get to hospital.”
“I feel so alone.”
“I had a freebirth last time because I couldn’t face the hospital. Now other women will too.”
“Midwives deserve better than this. They are leaving because the system is unsafe.”
“I worry constantly about what will happen when my labour starts.”
“This has caused so much fear for our family.”
“I feel completely dismissed.”
“I am scared of being coerced into interventions.”
“My previous induction was traumatic. I never wanted to be in that position again.”
“I feel devastated.”
“Hospital birth was the hardest experience of my life.”
“Home birth was the only option I felt safe with.”
“I cried for hours when I heard the news.”
“I live miles from a hospital and have no support.”
“I wanted a home birth to protect my mental health.”
“I feel I have no control.”
“I feel violated by this decision.”
“I feel trapped.”
“This has taken away my choices.”
“I can’t sleep properly with the anxiety.”
“I am grieving the birth I planned.”
“This suspension feels like the system doesn’t care about women at all.”
“I don’t feel I matter in this maternity system.”
“My home birth was beautiful — every woman deserves that choice.”
“I am terrified my baby will be harmed by unnecessary intervention.”
“We planned a calm birth at home. Now that’s gone.”
157 Signatories
Emma Gleave - Birth-Keeper, Doula, Advocate
Katherine Koteral – Independent Midwife – Alice Hopkin – Parent – Tracy Thomas – Director, Zest Midwives – Katy Shay – Director, Zest Midwives – Elle Masset – Mother, Birth Worker – Stroud Natalie Harrison – Birth and Postnatal Doula – Alexandra Burner – Doula, Doula Trainer, Birthed 3rd Child at Stroud MLU – Cheltenham Susanna Martin – Homebirth Mum – Dursley Lauren Woran – Homebirth & Gloucester Hospital – Forest of Dean Dr Lucy Martin – Planning a Homebirth – Stroud Melanie Atkinson – Local Doula – Louella Napleton – Homebirth Mum – Forest of Dean Lou Brownson – –
Christy Belshaw – Local mother – Cheltenham
Bethany Pollock – Expectant mother & mother – Frampton On Severn
Cassandra West – Doula, Mother, Daughter, Therapist – Bristol but work in Gloucestershire
Jasmine Lovell-Davis ND – Mother, homebirther and naturopath – Forest of Dean
Alice Hopkin – Mother – Cheltenham
Dr Romi Barrett – Clinical Psychologist, Mother-to-be – Forest of Dean
Jordan Warren – Mother – Forest of Dean
Matthew Barrett – Father – Coleford
Dr Susanna Martin – Previous home birther, potential free birther – Dursley
Gail Daniel – Doula – South Gloucestershire
Anon – – Forest of Dean
Gillian Holmes – Mother – Stroud
Deborah Hannam – Mother – Tewkesbury
Jessie May Peters – Mother – Stroud
Luna Dewey – Mother, educator – Stroud
Katie Wyman – Mother – Stroud
Abi Williams – Mother – Lydney
Emma Weaver – Mother – Lydney
Laura Maclennan – Parent –
Emile Dodin – Father – Cotswolds
Victoria Graham – Mother, local parent – Cheltenham
Sophie Bennett – Mother – Brockworth
Olivia James – Expectant mother – Gloucester
Charlotte Evans – Doula – Stroud
Kirsty Clarke – Mother – Gloucester
Georgia Parker – Expectant mother – Newent
Daisy Meredith – Local mother – Gloucester
Rebecca Hale – Mother – Stroud
Melanie Dodd – Mother, local resident – Cheltenham
Sarah Milton – Mother – Gloucester
Emma Wright – Mother – Stroud
Hannah Collins – Mother – Forest of Dean
Rhiannon Price – Parent – Gloucester
Lara Jennings – Expectant mother – Cheltenham
Melissa Ford – Mother – Stroud
Hannah Oakley – Local mother – Forest of Dean
Laura Daniels – Mother – Gloucester
Claire Bishop – Parent – Cheltenham
Jenny Ellis – Mother – Stroud
Emily Hughes – Local parent – Gloucester
Hannah Turner – Mother – Newent
Hollie Andrews – Expectant mother – Cheltenham
Kelly Roberts – Mother – Gloucester
Heather Green – Doula & mother – Stroud
Sophie Grant – Mother – Cheltenham
Sarah Williams – Parent – Stroud
Katherine Lewis – Parent – Gloucester
Alexandra Sykes – Mother-to-be – Forest of Dean
Megan Clarke – Mother – Gloucestershire
Kerry Allen – Mother – Tewkesbury
John Thomas – Father – Gloucester
Roisin Doyle – Mother – Forest of Dean
Jess Matthews – Parent – Stroud
Chris Hunt – Father – Cheltenham
Zara Wilson – Mother – Gloucester
Phoebe Turner – Expectant mother – Forest of Dean
Alice Morton – Parent – Cheltenham
Maria Stevens – Parent – Gloucester
Helen Doherty – Local mother – Stroud
Gemma O’Connor – Parent – Forest of Dean
Claire Turner – Mother – Cheltenham
Ruth Jennings – Mother – Stroud
Maya Roberts – Parent – Gloucester
Naomi Watson – Local mother – Cheltenham
Emily Carter – Mother – Cotswolds
Hannah Webb – Parent – Forest of Dean
Charlotte Young – Mother – Gloucester
Sammy Day – Parent – Lydney
Aimee Taylor – Expectant parent – Cheltenham
Danielle Moore – Mother – Stroud
Lucy Bennett – Parent – Gloucester
Kate Andrews – Mother – Cheltenham
Carla Hughes – Parent – Forest of Dean
Jade Cooper – Mother – Gloucester
Emma Hart – Expectant mother – Stroud