Freedom of Information Request – Stroud Maternity Unit & Planned Home Birth Activity

The figures requested in the FOI written below do not necessarily reflect the true demand for community birth services in Gloucestershire.

Many women report that they are never fully informed about the well-evidenced benefits of midwife-led and home birth settings for low-risk pregnancies. Instead, conversations are often framed around what is not available outside an obstetric unit — for example, epidurals, continuous obstetric presence, or surgical intervention — with comments such as “if you may need transfer anyway, you might as well already be in hospital.”

This framing can discourage women from considering community birth options in the first place.

Research consistently shows that for women with straightforward pregnancies, planned birth in midwife-led settings is associated with lower rates of intervention, including induction, instrumental birth, episiotomy and caesarean section, alongside higher rates of physiological birth and maternal satisfaction. Babies are also less likely to experience iatrogenic complications associated with unnecessary intervention and separation from their mothers.

We have received information that around 80% of women are now considered “high risk.”

If this is accurate, it still means approximately 20% of women remain eligible for community birth settings. Local services should therefore be planned to safely support at least this proportion of births.

If significantly fewer women are accessing community birth options, serious questions must be asked about:

• whether women are receiving balanced and evidence-based information about place of birth,

• whether genuine informed choice is being supported,

• and whether women are increasingly being funnelled into more intervention-heavy obstetric settings by default.

This matters because obstetric-unit birth is associated with higher rates of:

• continuous fetal monitoring,

• epidural and opioid pain relief,

• instrumental delivery,

• episiotomy and severe perineal trauma,

• emergency caesarean section,

• and neonatal admissions to special care.

Community birth is not the right choice for every woman.

But women deserve access to accurate information, lawful choice, and maternity services designed around evidence — not false narratives, assumptions, fear, staffing pressures, or institutional culture.

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Dear Freedom of Information Team,

Under the Freedom of Information Act 2000, I would like to request the following information relating to maternity services provided by Gloucestershire Hospitals NHS Foundation Trust.

Please provide data for each of the last five complete financial years (or calendar years if easier).

1. Planned Home Births

For women booking a planned home birth within the Trust catchment area, please provide:

• The number of women who planned a home birth at the onset of labour.

• The number of births that took place at home.

• The number of women who transferred to hospital during labour.

• The number of women who transferred postnatally after a home birth.

If available, please provide the primary recorded reason for transfer (for example: request for epidural, slow progress, fetal concerns, meconium, maternal request, etc.).

2. Stroud Midwife-Led Unit

For Stroud Maternity / Midwife-Led Unit, please provide:

• The number of women who laboured at Stroud.

• The number of births that took place at Stroud.

• The number of women who transferred from Stroud to an obstetric unit during labour.

• The number of women who transferred after birth.

If available, please provide the primary recorded reason for transfer.

3. Planned Place of Birth

For context, please also provide:

• The number of women who booked Stroud Midwife-Led Unit as their planned place of birth at the onset of labour for each year.

If the information is held in a different format (for example within the maternity information system), please provide the closest available equivalent data.

If any part of this request would exceed the appropriate cost limit, please advise how it could be refined so that the information can be provided.

I would prefer the information in electronic spreadsheet format if possible.

Kind regards,

Gloucestershire Maternity Action Group