UK Midwifery Units Face Closure Amid Staffing Crisis
A staffing crisis in the UK's maternity services has led to calls to close freestanding midwifery-led units (MLUs) to reallocate staff to consultant-led units. Government policies separating MLUs from obstetric services are cited as exacerbating risks, with reports noting that 150 MLUs have been built since 2000 without a corresponding increase in midwives, leading to understaffing.
The chronic shortage of midwives is a key driver of these closures, with the Royal College of Midwives (RCM) estimating England's NHS is short of over 2,000 full-time midwives. This staffing crisis is not new; before the pandemic, nearly one in ten midwifery posts were vacant, a figure that doubled as the crisis took hold. The strain on the existing workforce is immense, with midwives working an estimated 100,000 unpaid hours weekly to maintain services. The impact on patient care and choice is significant. Between May 2020 and April 2024, maternity wards in England were forced to close to new admissions on 2,201 occasions, largely due to staffing shortages. These closures disproportionately affect low-risk women who would be ideal candidates for midwifery-led units, pushing them into consultant-led units where medical interventions are more likely. This trend directly contradicts the goals of the "Better Births" policy, which aims to increase choice and promote midwife-led care. Evidence consistently shows that for low-risk pregnancies, midwifery-led units offer safe and effective care with lower rates of intervention. One Irish randomized trial found that women in midwife-led care had similar rates of caesarean birth, induction, and episiotomy as those in consultant-led care, but with significantly less electronic fetal monitoring and labor augmentation. Closing these units can lead to a cascade of interventions and may negatively impact the birthing experience. The financial pressures on the NHS are exacerbating the crisis. In April 2025, it was revealed that the national Service Development Funding for maternity services would be slashed from £95m in 2024-25 to just £2m in 2025-26. The RCM has described these cuts as "utterly shocking" and warned they will compromise the delivery of safe maternity care. This reduction in funding puts at risk extra posts that would support complex pregnancies and bereavement care. The Royal College of Midwives has been actively campaigning against these closures and for safer staffing levels. Their "Safe Staffing = Safe Care" campaign highlights the urgent need for investment in the midwifery workforce to ensure the safety of mothers and babies. The RCM has also raised concerns about the long-term impact on the profession, as a lack of exposure to low-intervention births in MLUs could erode the skills and confidence of midwives. The crisis extends to the pipeline of new midwives. A recent survey by the RCM found that despite chronic staffing shortages, almost one in three newly qualified midwives have been unable to find a job. Of those who have found roles, 55% are on fixed-term contracts, and 53% are not working full-time, indicating a disconnect between the need for midwives and the availability of secure positions. This situation is compounded by a 12.5% drop in the number of UK-educated midwives joining the professional register.
