THE Island’s home birth service will not be available “24/7 and 365 days a year” when it is reinstated without a significant increase in the Health budget, the Health Minister has admitted.
The Health Department recently paused support for mothers wanting to have their babies at home until an internal review was carried out into the service.
The Hospital’s director of midwifery, Ros Bullen-Bell, said that the service was “temporarily paused [but] we remain fully committed to reinstating it promptly once the review is completed”.
But speaking to the JEP, Health Minister Tom Binet said that even after the review, home births “will not be a service that is available morning, noon and night”.
“It is very unlikely that we are going to be able to have a 365 days per year, 24/7 service for home births on the budget we have right now,” the minister said.
“If we could have delivered that we would already be doing it. In an ideal world everyone would have everything they want, [but] every area of health is crying out for more money.”
He said that it was “a shame if a woman can’t have a home birth and wanted one” but that the priority for his department was “keeping everyone safe”.
In the States Assembly this week, Assistant Health Minister Andy Howell – who has responsibility for women’s health matters – said that the service would not be reinstated until later this year after a UK company had come to the Island to train 40 local midwives. She told States Members the service had been paused due to a shortage of trained midwives.
The Hospital supported 45 home births in 2022 and 43 in 2023 but only nine last year. It was “temporarily” suspended to assess protocols, staff training and resources.
Ms Bullen-Bell said: “I want to reassure expectant parents that our team is dedicated to supporting them in achieving their desired birth experience within our recently reopened Maternity Unit, which features a dedicated midwife-led unit.”
Jersey is not alone in struggling to cater for home births amid reduced department budgets, and a number of NHS Trusts have also suspended or reduced the service.
In November, Manchester University NHS Foundation Trust suspended its home birth service due to staff sickness and rota issues.
According to Birthrights, a UK organisation that promotes maternity rights, NHS trusts are expected to provide a home birth service unless there are compelling reasons not to.
They stress that healthcare providers must ensure adequate staffing to deliver promised services and should have contingency plans in place for staff shortages.
The organisation said: “A trust should only pause their home birth service if they have looked at all the options for keeping it going and they are still unable to.
“This could include providing an independent midwife.”
The decision to pause the service in Jersey comes against a backdrop of wider challenges in maternity care.
A critical report published in 2021 found that Jersey’s maternity facilities were “inadequate and highly unacceptable”, and should be upgraded as soon as possible.
A total of 127 recommendations were made in response to the review in the Maternity Improvement Plan – 87 of which had been completed as of this month.
In April 2024, an inquest into the death of baby Amelia Clyde-Smith – who was just 33 days old when she died – found that “failings in the midwifery team” and “neglect” on the labour ward contributed to the tragedy.
A leading midwifery union raised concerns about persistent “poor culture” and retention issues within the department in late 2023.
The Royal College of Midwives found a “perception among staff that maternity management are not prioritising their health and wellbeing” and that midwives had been left unable to take any breaks when working 13.5-hour day shifts and 11.5-hour night shifts.
At the time, the Health and Community Services’ executive team described the concerns as “somewhat out of date”.
“At the time that this was submitted the RCM may not have been fully aware of developments over the last year to improve maternity services,” the team explained.
The executive team added that a “substantial programme of change work has been conducted by the division and directed at executive level”.
