FOI Request – Internal Proposal and Rationale for Reinstating Home Birth Services
Why We Are Asking About the Evidence Behind the Trust’s Home Birth Plan
There are a number of safe, evidence-based models for continuity of carer and community-based midwifery already operating across the UK.
Gloucestershire Maternity Action Group wants to know which of these models Gloucestershire Hospitals NHS Foundation Trust has properly reviewed before developing its current proposal for reinstating home birth services.
Continuity of care means that a woman is supported by the same midwife, or a small known team of midwives, throughout pregnancy, labour, birth and the postnatal period. This does not mean working in isolation from obstetricians or doctors. It means that, when additional medical input is appropriate, it happens within a relationship of trust, with a midwife who knows the woman, understands her history, and can support safe, personalised decision-making.
The evidence for midwifery continuity of care is overwhelming.
The 2024 Cochrane Review found that women receiving midwife continuity of care were less likely to experience caesarean birth or instrumental birth, more likely to have a spontaneous vaginal birth, and more likely to report positive experiences during pregnancy, labour and postnatally.
The review also found cost savings in antenatal and intrapartum care.
Previous Cochrane evidence has also associated midwife-led continuity models with reduced preterm birth and reduced fetal loss before 24 weeks’ gestation, although the 2024 review is more cautious about certainty in some outcomes.
GMAG believes it is unethical for Gloucestershire to ignore established, evidence-based models of community midwifery while proposing an apparently improvised staffing model that may leave women without reliable access to home birth or midwife-led care. Women giving birth are, by nature, in a vulnerable position.
Removing access to known, trusted midwives and lawful community birth choices places women and babies at a disadvantage, particularly those who are already marginalised, traumatised, or less able to advocate for themselves.
We believe this raises serious questions about safety, equality, informed choice and human rights. If the Trust has chosen not to provide the gold-standard model of care, the public has a right to know what evidence, risk assessments and figures have been used to justify that decision.
This Freedom of Information request asks the Trust to disclose the evidence base, modelling and assumptions behind its current proposal for reinstating home birth services.
Dear Freedom of Information Team,
Please treat this as a request under the Freedom of Information Act 2000.
I am requesting information relating to the Trust’s current internal proposal, plan, or options for reinstating NHS-supported planned home birth services in Gloucestershire.
Please provide the following:
1. Current internal proposal
Please provide the most recent internal proposal, briefing paper, options appraisal, implementation plan, or decision paper relating to the reinstatement of planned home birth services.
This includes any document setting out the proposed staffing model, rota model, on-call arrangements, service restrictions, phased reinstatement plan, or conditions under which home birth services may resume.
If there is more than one current proposal or option under consideration, please provide the latest version of each.
2. Risk assessment and governance
Please provide the most recent risk assessment, quality impact assessment, equality impact assessment, clinical safety assessment, or governance paper relating to the proposed reinstatement model for planned home birth services.
If these are recorded separately, please provide the current risk register entry or governance summary relating to the reinstatement of home birth services.
3. Figures and assumptions used to support the rationale
Please provide the figures, calculations, datasets, assumptions, or modelling used by the Trust to support the rationale for the current proposed reinstatement model.
I am not requesting a full historic activity dataset under this question. I am specifically requesting the figures and assumptions relied upon in forming or justifying the current proposal.
This may include, for example:
expected number of planned home births per month;
expected staffing requirement per home birth;
assumed number of midwives required on call;
assumptions about transfer rates;
assumptions about geographical coverage, travel time, or response time;
assumptions about simultaneous demand across home birth and community birth settings;
any calculations used to assess whether the proposed model can safely meet expected demand.
4. Communications between Chief Executive and Chief Nurse
Please provide emails and attachments between Kevin McNamara, Chief Executive, and Matt Holdaway, Chief Nurse, from 1 November 2025 to the date of this request, where the subject matter relates to the reinstatement of planned home birth services.
To keep this request focused, please limit this to communications concerning:
the proposed reinstatement model;
staffing or rota arrangements;
risk assessment;
cost or resource implications;
the figures, assumptions, or rationale used to support the proposal.
5. Briefings or communications to midwives
Please provide any briefing, email, staff update, FAQ, or written communication issued to midwives or maternity staff from 1 November 2025 to the date of this request regarding the proposed reinstatement of planned home birth services.
Please include documents explaining the proposed model, expected staffing arrangements, rota changes, or how midwives should respond to women requesting home birth.
Please provide the information electronically.
If any part of this request is likely to exceed the cost limit, please do not refuse the request outright.
Please provide advice and assistance under section 16 of the Freedom of Information Act to help narrow the request.
Yours faithfully,
Emma Gleave
Gloucestershire Maternity Action Group