Mapping midwifery and obstetric units in England

- Numbers of alongside midwifery units have nearly doubled since 2010
- Numbers of free-standing midwifery units have remained stable since 2010
- Twenty four per cent of local maternity services have no midwifery units
- Fourteen per cent of women give birth in midwifery units, about a three-fold increase since 2010
- In places where there are midwifery units, the percentage of women giving birth in them varies from 4% to 31% across England

Objectiveto describe the configuration of midwifery units, both alongside&free-standing, and obstetric units in England.Designnational survey amongst Heads of Midwifery in English Maternity ServicesSettingNational Health Service (NHS) in EnglandParticipantsEnglish Maternity ServicesMeasurementsdescriptive statistics of Alongside Midwifery Units and Free-standing Midwifery Units and Obstetric Units and their annual births/year in English Maternity ServicesFindingsalongside midwifery units have nearly doubled since 2010 (n = 53-97); free-standing midwifery units have increased slightly (n = 58-61). There has been a significant reduction in maternity services without either an alongside or free-standing midwifery unit (75-32). The percentage of all births in midwifery units has trebled, now representing 14% of all births in England. This masks significant differences in percentage of all births in midwifery units between different maternity services with a spread of 4% to 31%.Key conclusionsIn some areas of England, women have no access to a local midwifery unit, despite the National Institute for Health&Clinical Excellence (NICE) recommending them as an important place of birth option for low risk women. The numbers of midwifery units have increased significantly in England since 2010 but this growth is almost exclusively in alongside midwifery units. The percentage of women giving birth in midwifery units varies significantly between maternity services suggesting that many midwifery units are underutilised.Implications for practiceBoth the availability and utilisation of midwifery units in England could be improved.