Up to 20 maternity units in England will have to shut to ensure mothers and babies receive safe care amid shortages of doctors and rising caesarean section rates, an NHS leader has warned.
Matthew Hopkins, the NHS Alliance’s director for acute care, said centralising childbirth services into fewer hospitals was “inevitable” and the “right thing”, but would lead to a political backlash against unpopular changes.
Ministers must “grasp the nettle” that as many as 20 of England’s 155 NHS units that are led by consultant obstetricians will need to shut or change their role, he added.
Smaller maternity units that deliver only 1,500 to 2,000 babies a year are becoming increasingly unsustainable because of a widespread lack of obstetricians and a sharp rise in recent years in the number of women having either a planned or emergency caesarean section, he added.
Many of the units most at risk are in rural or coastal areas, where staffing is particularly challenging, he told the Guardian. “We are calling for a thorough appraisal of maternity services and where they need to be located because the current configuration is not fit for purpose,” Hopkins said.
“Difficult decisions lie ahead, consolidating maternity services to support safer, more sustainable care.
“If politicians … are keen to see safe maternity services in their area, it is going to need courage to grasp the nettle that needs to be grasped in order to improve maternity services.”
Source: The Guardian, 19 October 2026
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