The Midwife Shortage in the UK: What Does It Mean for Your Birth Choices?
If you are pregnant in the UK in 2026, you may have heard about the pressure on maternity services and the shortage of midwives.
You may also have heard that birth centres are closing, home birth services can be restricted, or that maternity teams are working under enormous pressure.
And perhaps you are wondering:
Will the midwife shortage affect my birth choices? What does this mean for me and my baby?
Does it affect where I can give birth? Will I have a midwife with me during labour? Can I still choose a home birth or a midwife-led unit? And how can I prepare for birth when the maternity system itself feels stretched?
These are very reasonable questions.
The situation is complex, and it is important not to let alarming headlines make you feel frightened or powerless. At the same time, it is worth understanding what is happening so that you can prepare realistically, ask good questions and make decisions that feel right for you.
1. What is happening with midwifery in the UK in 2026?
There isn't one simple number that captures the UK-wide midwife shortage.
In England, NHS workforce data show that there were 25,471 midwives in post in May 2026, measured as full-time equivalent staff in the NHS acute hospital workforce. This represents an 18% increase compared with 2019.
So why are we still talking about a shortage?
Because headcount alone doesn't tell us whether maternity services have enough staff, in the right places, with the right experience and skill mix, to provide safe one-to-one care.
The Royal College of Midwives' 2026 survey gives us a much clearer picture of what working life currently looks like for many maternity professionals.
More than 3,500 maternity staff responded to the RCM's June 2026 survey. Of those respondents:
77% said their team or unit was not safely staffed during the week surveyed.
77% worked unpaid hours beyond their contracted shifts.
93% said staffing levels affected the quality of care they were able to provide to women and babies.
72% said staffing felt unsafe on more than half of their shifts over the previous month.
Three quarters had considered leaving the profession in the previous year.
There is another striking part of the 2026 picture.
At the same time as maternity services are reporting significant workforce pressures, 31% of newly qualified midwives who had received their professional registration had not secured a midwifery position, according to an RCM survey. Among those who had not found a job, 61% reported that they were not working at all.
This sounds contradictory: how can there be staffing shortages while newly qualified midwives cannot find jobs?
The answer appears to be partly about funding, recruitment freezes, geography, workforce planning and the difference between having qualified professionals available and having funded, sustainable posts available within individual maternity services.
The RCM has described this as a serious disconnect between the number of midwives being educated and the number of secure jobs available to them. The Government, meanwhile, has described the situation in terms of a mismatch between available roles and demand rather than simply an overall shortage.
Why does staffing matter to women?
Because midwifery isn't simply about having a midwife somewhere in the building.
Good maternity care depends on having enough appropriately skilled staff to provide emotional support, assessment, monitoring, clinical care, emergency response and, in an ideal world, continuity and one-to-one support during labour.
2. What does this mean for you when choosing where to give birth?
Your place of birth is not simply a logistical decision. It is about where you are likely to feel safe, supported and able to make decisions, as well as what clinical resources you may need.
For women who are healthy and experiencing a straightforward pregnancy, UK guidance recognises four broad birth settings:
home
a freestanding midwifery unit
an alongside midwifery unit
an obstetric unit in hospital.
NICE guidance states that women should be able to choose between these settings and should be supported in their choice. It also recommends that local information includes the likelihood of being cared for by a familiar midwife and the likelihood of receiving one-to-one care during labour.
That is important in the current climate.
Your preferred birth place may not always be available in exactly the way you imagined
The majority of UK Maternity services regularly experience staffing pressures.
This can affect the availability of home birth teams or midwife-led units. A birth centre may occasionally need to close or change its service because staff are required elsewhere.
AIMS has highlighted the fact that home birth services and birth centres can be subject to restrictions or short-notice changes because of staffing pressures.
This can be incredibly frustrating if you have spent months preparing for a particular birth.
But there is an important distinction:
A service being under pressure does not mean that your preferences no longer matter.
It means you may need to become more informed and more flexible about how you achieve the things that matter most to you.
Think beyond the location
Instead of asking only:
"Where do I want to give birth?"
try asking:
"What do I want my birth experience to feel like, and what do I need in order to feel safe and supported?"
Perhaps you want:
privacy
calm
freedom to move
access to water
minimal unnecessary intervention
continuity of care
informed consent
your partner involved
time to make decisions
reassurance rather than fear
a sense that your voice matters
access to medical support if you need it.
Mot of the time, these preferences can travel with you.
Your ideal birth location is important, but your values and preferences are bigger than a particular room.
This can be especially helpful if circumstances change during pregnancy or labour.
What if your chosen birth place isn't available?
This is something I would encourage every pregnant woman to think about - not because you should expect things to go wrong, but because having a Plan B can actually make you feel calmer.
For example:
Plan A: Home birth
Plan B: Midwife-led unit
Plan C: Obstetric unit, if medically indicated or if that is what feels right to you.
And alongside those plans, think about:
What matters most to me regardless of where I give birth?
Maybe your priorities are:
avoiding unnecessary intervention
being able to move freely
using breathing and relaxation techniques
having your partner actively involved
having the lights low
using water
being spoken to respectfully
understanding why something is being suggested
having time to consider your options wherever it is clinically possible.
Those things can form the foundation of your birth preferences.
Birth choice is still your choice
It can be easy to assume that because maternity services are under pressure, you simply have to accept whatever is offered.
But informed choice remains important.
NICE says that women should be empowered, informed and central to decisions about their care. It specifically states that women can accept or decline care that is offered, can change their minds, and should be supported in making decisions.
AIMS also has an excellent guide to choosing your place of birth, including questions about local transfer arrangements, pain relief, birth pools, statistics and the practicalities of different settings.
This doesn't mean saying "no" to everything.
It means being able to say:
"Can you explain why you are recommending this?"
"What are my options?"
"What would happen if we waited?"
"What are the benefits and risks for me and my baby?"
"Is this an emergency, or do I have time to think?"
And sometimes simply:
"I need a moment to talk this through with my birth partner."
3. How can hypnobirthing and women-centred birth preparation help?
Antenatal education cannot solve a staffing shortage, however good it is.
Equally, Hypnobirthing cannot guarantee a particular birth experience, or should ever be presented as a way of avoiding medical intervention or as a promise of a particular type of birth.
But good birth preparation can give you something extremely valuable:
a greater sense of confidence and agency within an unpredictable system.
For me, this is where hypnobirthing can be particularly powerful.
It is not about pretending birth will always be calm, painless or straightforward.
It is about learning how to work with your body, understand what is happening, release fear, communicate your needs and remain grounded when circumstances change.
Hypnobirthing can give you practical tools
My Hypnobirthing method include:
understanding the physiology of labour
releasing fear and anxiety
creating a calm birth environment
techniques for working with sensations during labour
breathing techniques
relaxation
visualisation
positive language
biomechanics for birth and movement
preparing your birth partner to become an active source of support.
But perhaps one of the most important parts of good birth preparation is understanding your choices.
You don't need to know everything about maternity care.
You do need to know enough to participate confidently in conversations about your care.
Preparation isn't about writing the perfect birth plan
A birth preferences document can be useful, but I encourage women to think beyond a list of preferences and instead develop what I call birth confidence.
That means knowing:
what is important to you
what helps you feel safe
what your options are
how to ask questions
how to communicate with your maternity team
how your partner can support you
how to make decisions if circumstances change
where to find trustworthy information.
This approach can be particularly reassuring when the maternity system is under pressure.
You are not trying to control every variable.
You are preparing yourself to meet whatever happens with knowledge, flexibility and support.
Five ways to feel more confident in the current maternity system
1. Find out what is actually available locally
Don't rely solely on national headlines or stories from friends.
Ask your own maternity team:
Which birth settings are currently available?
Is home birth currently being offered?
Are there any restrictions?
What happens if staffing levels are low?
How often does the midwife-led unit close or divert women elsewhere?
What happens if I arrive and the unit is full?
What are the local transfer arrangements?
Services can change, so check again later in pregnancy.
2. Learn how to have informed conversations
You don't need to become an expert in obstetrics, but you and your partner need to become comfortable asking questions.
A useful framework is:
What are my options?
What are the benefits?
What are the risks?
What happens if we do nothing for now?
How urgent is this decision?
How does this affect my other choices?
3. Prepare your birth partner
Your birth partner's job is simple but incredibly valuable.
They should help you feel safe by protecting your space.
They should help you find calm and comfort.
They should help you nurture confidence and self-trust.
They can remind you of your breathing.
And most importantly, they can ask questions and advocate for your choices when you are concentrating on labour.
For example, they can say:
"Can you explain that to us?"
or
"She'd like a little time to think about that."
or simply:
"We're listening."
A well-prepared birth partner can be an enormous source of continuity and reassurance throughout labour.
4. Build your own support network
Your NHS maternity team remains central to your clinical care.
But you don't have to rely on one person or one service for every kind of support.
Consider who can support you emotionally, practically and physically.
This might include:
your partner
family or friends
a hypnobirthing educator
a doula
local groups
evidence-based pregnancy and birth organisations.
A doula, for example, does not replace a midwife.
A doula provides continuous emotional and practical support, while the midwife is a registered healthcare professional responsible for clinical care.
That distinction is important, and the two roles can complement one another beautifully.
You might also chose a private midwife who will be able to offer continuity of care and 1:1 birth and postpartum support.
5. Have a Plan B without giving up on Plan A
This may be one of the most useful things you can do.
Having an alternative plan isn't admitting defeat.
It is preparing for uncertainty.
You can hold your preferred birth very positively while also asking:
"If this isn't possible, what would help me feel safe and supported instead?"
That mindset can reduce the feeling that there is only one possible "good" birth.
Because birth isn't a test you pass or fail.
Sometimes the most empowering birth is the one in which you understand what is happening, have been involved in the decisions and feel that you and your baby have been cared for with respect.
5. Where can you find reliable information and support?
There is a huge amount of birth information online, and unfortunately not all of it is equally reliable. Here are some places I recommend exploring.
Sara Wickham
Dr Sara Wickham's work is particularly useful if you want to understand evidence, risk and informed decision-making without being told what decision you should make.
Her writing explores pregnancy, birth, maternity care and the ways that information is communicated to women. Sara Wickham's website
AIMS: Association for Improvements in the Maternity Services
AIMS is an independent organisation providing information and support around pregnancy and birth.
Their information on choosing your place of birth is particularly useful when you are weighing up home birth, a midwife-led unit and an obstetric unit.
They also run an information and support helpline.
NICE
For evidence-based clinical guidance, NICE is an excellent place to start.
Its current intrapartum-care guidance covers the different places women can give birth and the evidence around them. It also emphasises that women should be supported in their choice of birth setting and kept informed about local circumstances, including access to midwives and one-to-one care.
Pregnant in Bristol: local doulas and birth support
If you would like additional continuous emotional and practical support, there are wonderful doulas working across Bristol and the surrounding area.
I have listed trusted local options here: https://www.poppyandjack.co.uk/thevillage.
When choosing a doula, I would encourage you to look beyond qualifications and testimonials. A highly skilled and experienced doula may not be the best fit for you if someone with a couple fewer years of experience makes you feel safer, more comfortable and completely yourself.
Have a conversation.
Do they listen with care and compassion?
Do they support informed choice rather than telling you what kind of birth you should have?
You don't have to navigate this alone
The current state of maternity services can feel unsettling. There are genuine workforce pressures. Midwives are telling us that staffing levels are affecting their ability to provide the care they want to give. Maternity services are facing increasing clinical complexity, and national reports continue to highlight the importance of workforce capacity and safe staffing. But none of this means that you have to approach your birth feeling frightened or powerless.
You can prepare. Your birth partner can prepare.
You can ask questions.
You can learn about your options.
You can find out what is happening locally.
You can choose the things that matter most to you.
You can build a wider circle of support.
And you can learn skills that help you remain calm, grounded and connected to yourself if plans change.
If you would like to explore how I can support you through antenatal and Hypnobirthing classes or 1:1 birth mindset coaching, please get in touch via the contact form.
