Freedom of Information Request – Independent Midwife Provision for Planned Home Birth Support
Across the country, NHS Trusts have used Independent Midwives to help maintain safe, lawful maternity provision when local services are under pressure. This can be a practical way to uphold women’s right to choose the place of birth that is right for them, rather than simply removing options when NHS staffing becomes difficult.
Independent Midwives are fully qualified, NMC-registered midwives.
They have the same core training and professional registration as NHS midwives, and many bring extensive experience in continuity of care, physiological birth, home birth, breech birth, VBAC, and complex decision-making outside standard hospital pathways.
When Independent Midwives are contracted to support NHS provision, they can work alongside NHS midwives and obstetric teams. This does not just “plug a gap” in the short term; it can also help rebuild confidence, share skills, and strengthen community birth provision for future women. Used well, this should be a win-win situation: women retain access to safe midwifery care, NHS teams gain experienced support, and community birth skills are not lost.
We understood from Chief Nurse Matt Holdaway that discussions were underway with Zest Midwives about supporting home birth provision in Gloucestershire. We are therefore deeply concerned and confused to hear that the Trust is instead moving towards a model where a very small number of on-call midwives may be expected to cover community birth across the whole county.
This raises serious questions. Why has Independent Midwife support not been used to protect women’s choices? What options have actually been considered? What risk assessments have been carried out? Who has been consulted? And how have these decisions been made?
This Freedom of Information request seeks to understand what discussions, consultations, assessments and decisions have taken place regarding Independent Midwife provision in Gloucestershire, and whether all reasonable options have been properly explored before women’s access to planned home birth is restricted further.
Dear FOI Team,
Please treat this as a request under the Freedom of Information Act 2000.
I am requesting information relating to any discussions, consultations, assessments, or decision-making by Gloucestershire Hospitals NHS Foundation Trust regarding the possible use of independent midwives to support planned home birth provision during the current suspension/restriction of the NHS home birth service.
Please provide the following information from the date the home birth service was first suspended/restricted to the present date.
1. Discussions with independent midwives
Please provide copies of any recorded correspondence, meeting notes, briefing papers, emails, letters, contracts, draft contracts, or internal summaries relating to discussions with independent midwives or independent midwifery organisations about supporting planned home birth provision in Gloucestershire.
This should include any correspondence or records relating to:
whether independent midwives could support NHS planned home births
possible contractual arrangements
governance arrangements
indemnity or insurance
referral pathways
escalation arrangements
payment or funding arrangements
clinical accountability
eligibility criteria for women using the service
any proposed start date, pilot, interim arrangement, or temporary arrangement
2. Organisations or individuals approached
Please confirm whether the Trust has contacted, consulted, or held discussions with any independent midwives or independent midwifery organisations in relation to home birth provision.
For each organisation or individual contacted, please provide:
the name of the organisation, where this can lawfully be disclosed
the date of contact
the purpose of the contact
whether any proposal, quotation, contract, or service model was discussed
the current status of those discussions
Where personal names are exempt from disclosure, please provide the organisation names and role titles instead.
3. Options appraisals and internal decision-making
Please provide any records of internal consideration of independent midwife support as an option for maintaining or reinstating planned home birth provision.
This should include:
options appraisals
decision logs
risk assessments
briefing notes
meeting minutes
governance papers
business cases
financial assessments
legal advice summaries, where disclosable
procurement assessments
reports or recommendations to senior leadership
4. Reasons for accepting or not accepting independent midwife support
Please provide any recorded information setting out the Trust’s reasons for either:
pursuing independent midwife support
not pursuing independent midwife support
pausing discussions
ending discussions
deciding against any proposed independent midwife arrangement
deciding that independent midwife support was not suitable, necessary, affordable, or operationally feasible
This should include any recorded concerns relating to:
clinical governance
indemnity
insurance
procurement
contract management
cost
staffing
escalation arrangements
accountability
safeguarding
professional regulation
service-user safety
reputational risk
compatibility with Trust policies or NHS guidance
5. Risk assessments
Please provide any risk assessments, risk register entries, or governance records relating to:
using independent midwives to support planned home birth
not using independent midwives to support planned home birth
continuing to suspend or restrict planned home birth support
women choosing to freebirth or give birth without NHS midwifery support because planned home birth support is unavailable
women giving birth before arrival due to lack of community midwifery availability
delayed access to midwifery care at home
loss of public confidence in maternity services
6. Financial information
Please provide any costings, financial modelling, quotations, budget discussions, or value-for-money assessments relating to independent midwife support for planned home birth provision.
Please include any comparisons with:
bank staff
agency staff
overtime
in-house home birth cover
continuing suspension/restriction of the service
any alternative community birth staffing model
7. Consultation and stakeholder involvement
Please provide records showing whether the following groups were consulted, informed, or involved in discussions about the possible use of independent midwives:
Gloucestershire Maternity and Neonatal Voices Partnership
Gloucestershire ICB
NHS England South West
Health Overview and Scrutiny Committee
service users affected by the home birth suspension/restriction
community midwives
independent midwives
Gloucestershire Maternity Action Group
If no consultation or stakeholder involvement took place, please confirm that no recorded information is held.
8. Current position
Please confirm the Trust’s current recorded position on the use of independent midwives to support planned home birth provision.
Please provide any documents setting out:
whether this option remains under consideration
whether it has been rejected
whether it has been paused
whether any arrangement has been agreed
whether any arrangement has ended
what alternative arrangements are now being pursued
9. Search terms
For clarity, please search for records containing the following terms:
“independent midwife”
“independent midwives”
“IM”
“IMUK”
“Zest”
“Zest Midwives”
“home birth”
“homebirth”
“planned home birth”
“community birth”
“freebirth”
“unassisted birth”
“governance”
“indemnity”
“insurance”
“contract”
“procurement”
“risk assessment”
“interim arrangement”
“temporary arrangement”
If any part of this request is considered too broad, please provide advice and assistance under Section 16 of the Freedom of Information Act 2000 so that the request can be refined without losing the substance of the information sought.
Yours faithfully,
Emma Gleave
Gloucestershire Maternity Action Group