A new free-standing midwife led unit

Cheltenham and Gloucester have each had their own consultant led maternity hospitals for as long as anyone can remember. The NHS took them over in 1947, and “Cheltenham General” and “Gloucester Royal” have each delivered about 2,500 babies a year ever since.

That’s more babies than the largest of Amsterdam’s six maternity hospitals – the mighty Onze Lieve Vrouwe Gasthuis helps only 2,100 new people into the world every year. If Cheltenham was in Germany it would be among the largest maternity hospitals in the country – the huge Humboldt clinic  in Berlin, created by the merger of three smaller hospitals delivers only just over 3,000 women per year. But in England they were too small – the NHS loves centralisation – so in 2011 the maternity department in Cheltenham General closed, and the obstetricians all decamped to Gloucester Royal.

The people of Cheltenham were a bit miffed at having to go elsewhere to have their babies, so NHS managers created a midwife led unit (MLU) at the old Cheltenham General.  This was an excellent idea, because most low risk women have less interventions and just as good baby outcomes in such units.  The Cotswolds are full of “back to nature” ex pop stars and city financiers – just the place where natural childbirth should be popular. In theory 2/3 of the Cheltenham births could safely take place there, plus a good slice of the Gloucester ones. Maybe a couple of thousand.

Early numbers have been more modest. Gloucester delivered 5,200 babies last year, Cheltenham Birth Centre 423. The reason of course is that when push comes to shove, pun intended, low tech childbirth is not that popular. You can have water birth, bean bags and every sort of aromatherapy, but you can’t have an epidural in Cheltenham. If labour gets stuck and you need a Caesarean or forceps, it’s an ambulance to Gloucester.  It’s all perfectly safe, about 80 women made the trip last year, but not much fun in advanced labour. And Stroud Maternity Centre, a long established MLU just down the road, already catered for many of those who really wanted a low tech birth, about 250 women a year.

And 423 births is a fine achievement. If Cheltenham can maintain 4-500 births per year that would place it among the largest free-standing MLUs in the country. If they can do it without fatally undermining Stroud, planners will surely regard it as a success.

Elsewhere the success of new free-standing MLUs, created when consultant units closed, has been mixed. Brent in North London (click here), Wakefield, Castle Hill in Hull, Llandough in South Wales, Southport, and Hemel Hempstead all closed after a few years. But Grantham, Maidstone, Neath & Port Talbot, Huddersfield, Edgware in North London, and Barkantine in the East End of London hang on.  Interesting to see how things pan out in the Cotswolds.

Jim Thornton