To scrutinise decision to suspend home birth services at Wye Valley Trust.

The committee considered a report on the Home Birth Services item.

The principal points of the subsequent discussion are summarised below:

1. The committee considered the item following concerns raised by residents regarding the suspension of the home birth service.

2. In introducing the item, the chairperson noted that a trust can suspend a home birth service where it concluded that the service could not be provided safely and that patient choice had to be balanced with patient safety, staffing levels and clinical governance.

3. The Director of Midwifery Wye Valley Trust explained that the review of the service had followed a high-profile case in Manchester and the publication of a prevention of future deaths notice, which identified key areas of concern including the absence of national guidance, issues relating to training and competence, and variation in service models.

4. It was noted that NHS England had formally asked the trust to undertake a review of its home birth provision, including the operational model, care planning and risk assessment, and the governance and oversight of the service.

5. The review, which began early in 2026, identified a decline in the home birth rate and, as a consequence, reduced exposure to home birth practice for some newer and longer-standing members of staff, creating concerns about maintaining competence.

6. It was also noted that changes to neonatal life support (NLS) guidance had also highlighted the need for additional equipment to support neonatal resuscitation while awaiting the arrival of paramedic colleagues.

7. The trust had completed the review and had taken action to increase staff exposure to intrapartum care, order the required equipment, begin training in its use, and strengthen operating procedures to support women in making informed choices about place of birth.

8. The Director of Midwifery Wye Valley Trust explained that the remaining step before recommending reinstatement of the service to the board was completion of training in neonatal resuscitation, although the timing remained dependent in part on the arrival of nationally sourced equipment.

9. In response to a question on timescales, the committee was advised that some of the required equipment had already been received and that a small number of midwives would be trained once the remaining equipment arrived, with the trust indicating that the process should take a number of weeks rather than months.

10. The Managing Director Wye Valley Trust advised that, once the equipment was available, training can begin and a recommendation would then be made to the board to reconvene the service, although a definitive date could not be given because the timing of equipment supply was outside the trust’s control.

11. It was noted that women considering a home birth were encouraged to contact the trust directly so that individual advice and support could be provided.

12. In response to questions about information for expectant mothers, the committee was advised that discussions about place of birth begin at the booking appointment and continue throughout the maternity pathway, with risks, benefits and alternatives considered as part of birth planning. It was also noted that information for families is now largely provided electronically, which enables written guidance and leaflets to be updated more easily.

13. The Director of Midwifery Wye Valley Trust added that work had been commissioned across the foundation group to develop a framework to support women to have personalised care.

14. In response to questions about future equipment availability, the committee heard that the trust intended to hold three emergency bags across the county, with spare equipment included, so that the necessary equipment would be available for home births.

15. The committee was advised that approximately 25 staff would require training and that this would be delivered in small groups so that the programme could be implemented promptly while maintaining community maternity services.

16. In relation to risk, the Director of Midwifery Wye Valley Trust explained that, where a woman had experienced a straightforward pregnancy and previous birth, it was statistically safer to have a second baby at home, whereas a first birth carried greater risk.

17. The Chairperson asked the trust to keep the committee updated on progress towards resuming the service.