Suspension of Home Births

2025.01.21

Deputy L.M.C. Doublet of St. Saviour the Minister for Health and Social Services regarding the suspension of Jersey's home birth service (OQ.2/2025):

Will the Minister explain why Jersey's home birth service has been suspended, advise what actions are being undertaken to reinstate the service, and when this service is expected to recommence?

Deputy T.J.A. Binet of St. Saviour (The Minister for Health and Social Services):

I wonder if the Deputy would allow me to hand this matter over to the Assistant Minister with responsibility for women's health.

Deputy A. Howell of St. John , St. Lawrence and Trinity (Assistant Minister for Health and Social Services - rapporteur):

The Minister for Health and Social Services and Assistant Ministers for Health and Social Services very much regret the temporary pause to the home birthing service. However, because we do not have enough trained midwives, we have been advised by the director of midwifery and nursing that the service has to cease temporarily. We have an obligation to support her expert professional opinion. This is to ensure that our maternity service is safe for our mums. There will be no exceptions. We have a duty of care and all our mothers and their babies are precious. The plan is for 40 local midwives to be trained in home births by a U.K. company who are to come over to Jersey to undertake the training in April/May 2025. Unfortunately, it cannot be sooner due to the training team having prior commitments. Concurrently, a review of the home birthing service is also taking place, with the outcome due by the end of June at the earliest. The plan is to reintroduce the home birthing service when all the staff have been appropriately trained, any recommendations for the review have been implemented and it is deemed safe to do so. In the meantime, all women have been offered care and support for the delivery of their babies within the maternity unit at the General Hospital. Women can use the midwife-led delivery suites, both with operational birthing pools. They can bring in their duvets, any items to personalise the space, and can return home as soon after the birth as it is safe. Finally, I would like to reiterate to Members and the public that the decisions being made are clinically-led, prioritising women on this Island and their safety.

1. Deputy L.M.C. Doublet :

I thank the Assistant Minister. The main purpose of this question is to assist with communication with members of the public. I note that the website currently states ... it is one sentence stating that home births are not possible currently. Could the Assistant Minister commit to updating that website to ensure that all of the information that she has just outlined, and more detail if possible, including some photos of the new facilities at the hospital and details on how women can make it more home-like, and critically information on when the service will be back up and running, that that is provided publicly on the website as soon as possible?

Deputy A. Howell :

I am very happy to provide that information.

2. Deputy P.M. Bailhache of St. Clement :

Bearing in mind that there are 46 midwives in the department, of which 5 are fully trained in home birthing, would the Assistant Minister be prepared to consider reinstating the home birth service for the benefit of those who wish to use it, subject of course to the availability of midwives and safety considerations while the internal review is being carried out?

Deputy A. Howell :

It is with regret but I have spoken to the director of midwifery and nursing and the interim chief nurse and the nurse who has come over with the change team, who is also a midwife, and they say unfortunately we can make no exceptions. The trouble is that if we send trained midwives out to look after a home birth it then might compromise the running of the maternity unit, because we have to run that maternity unit 24 hours a day, 365 days a year. It is with regret that we can make no exceptions at the moment.

3. Deputy P.M. Bailhache :

Would the Assistant Minister agree that, during the past 18 months or so, ad hoc arrangements have been made for home birthing?

Deputy A. Howell :

I understand that one more midwife has retired or gone on to other work, so we are unable to provide the service. It has been teetering on the edge during the whole of 2024. One day it may have been on, but the next day it was not on. That was not fair for people expecting that they might be able to have a home delivery and then being last minute told. I can assure the Deputy that any mother who is due to give birth was told ... since last June they have been given that information that they cannot be guaranteed home delivery.

4. Deputy H.M. Miles of St. Brelade :

What advice has the board given over the safety of our maternity services in general? Deputy A. Howell :

I thank the Deputy for her question. There has been a very large review of our maternity services and 127 recommendations were made, of which I think we have now completed 87. The whole of the maternity unit has been refurbished, and it is now as safe as it possibly can be.

5. Deputy H.M. Miles :

When did the board alert the Minister that there was a problem with maternity services? Deputy A. Howell :

Thank you for the question, Deputy . I do not think it was the board ...

The Bailiff :

Through the Chair, please.

Deputy A. Howell :

I am sorry, Sir. The maternity review was undertaken by the Government.

6. Deputy I. Gardiner of St. Helier North :

When did the Assistant Minister first become aware about safety concerns for home births? Deputy A. Howell :

I thank the Deputy for her question. I first knew about this last October, but the director of midwifery was very clear that she had made contact with all the mothers who were due to have any delivery.

7. Deputy I. Gardiner :

Thank you very much for the questions today for the Assistant Minister. [11:30]

Just to clarify if in the previous answer I have heard that the people were made aware about concerns in June, does it mean that between June and October officers tried to sort it out without notifying the Minister, and if yes, what actions were taken to ensure that their home births can continue safely?

Deputy A. Howell :

Operational matters within the hospital are not up to politicians and I was made aware in October.

8. Deputy G.P. Southern of St. Helier Central :

Is the Assistant Minister in a position to state how and why the company chosen was chosen? Deputy A. Howell :

This is again a matter for the director of midwifery and nursing, but I believe it is a very highly thought of training service and it is very important for our midwives.

9. Deputy G.P. Southern :

Could the Assistant Minister outline for Members how and why this company was chosen? Deputy A. Howell :

I have to repeat that it was down to the director of midwifery and nursing.

10. Deputy K.M. Wilson :

Can the Minister explain why we have got to a situation where the recruitment of midwives with this level of skill and competence has fallen to such levels given the considerable focus on maternity services over the last 12-18 months?

Deputy A. Howell :

I think it is as a result of the review that these matters have come to light, and I think we have also had the retirement of some very experienced midwives.

11. Deputy K.M. Wilson :

Could the Minister then provide some detail about how she intends to increase the number of midwives, not just through training and development but what is the wider recruitment plan for this?

Deputy A. Howell :

I do think the maternity unit is fully staffed at present.

The Bailiff :

Final supplementary. I am sorry, I had already called last questions.

12. Deputy L.M.C. Doublet :

Given the Assistant Minister has just stated that the unit is fully staffed, could she explain is it a rota issue that midwives cannot also go out to home births? That does not really seem to add up and further explanation would be helpful.

Deputy A. Howell :

It is a matter of training for our midwives that is key. They have to be trained in home births, and it has to be current training, and that is the reason that the home birthing has had to cease at the moment.