New proposals to revamp maternity services in Gloucestershire could require midwives to travel extensively across the county, according to recent discussions among health and local government officials.
The Gloucestershire Hospitals NHS Foundation Trust aims to safely reopen the maternity unit at Cheltenham General Hospital and reinstate the county’s home birth service later this year. Both services were suspended due to safety concerns—Cheltenham’s maternity unit in April 2022 and the home births program last November—leaving limited birthing options for families over the past four years.
At a Gloucestershire County Council meeting on May 26, Medical Director Mark Pietroni outlined a new on-demand maternity care model. This system would see midwives not permanently stationed at the Stroud maternity unit or Aveta Birth Centre but available whenever women go into labour. Under the plan, three midwives would be on call 24/7, supported by an additional midwife who could be called in from Gloucester hospital. The model is designed to be scalable to accommodate future birth rate increases.
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While the reopening of Cheltenham’s unit is welcomed by many, concerns remain about midwives’ travel burdens. Councillor Paul Hodgkinson highlighted that midwives might face significant travel around the county under the new system and expressed worry that postnatal care beds in Stroud would remain closed in the short term. The reopening of these beds is slated for NHS medium- to long-term planning stages.
Hodgkinson emphasized the importance of staff consultation, urging that midwives' views on the changes be carefully considered. “We must listen to NHS workers to understand their feelings and concerns,” he said. “It sounds like they will have considerable travel obligations—how is this being managed?”
Pietroni acknowledged the travel challenges but noted that midwives may live nearby their assigned areas. He stressed the priority of safety in the reopening timeline, aiming for autumn this year, and recognized that a four-year suspension can hardly be seen as temporary by many.
This approach reflects maternity service models used in other rural areas across England, potentially allowing Gloucestershire to learn from established practices elsewhere.
The council also heard about the evolving landscape of maternity care, including the rising complexity of births, disparities in care access and outcomes, and resources pressures. Health officials pointed out that current workforce arrangements and facilities no longer meet women’s changing needs, driving up costs without corresponding outcome improvements. Addressing these challenges is critical for financial sustainability and improved care quality.
Marie Croft, Chief Nursing Officer, described the existing maternity service model as “not fit for purpose,” highlighting the urgent need for enhanced performance to meet increasing population demands and case complexities. Helen Ford, Maternity Programme Director, echoed this sentiment, noting a growing demand for care continuity as women seek more consistent support throughout pregnancy and birth.
As Gloucestershire charts its path forward, balancing safe, accessible care with sustainable staffing remains the central challenge in restoration efforts.