Campaigner says Trowbridge area mums may not be able to get to hospital in time

They fear mothers without access to private or public transport will find it more difficult to get to the large birthing units in Bath, Salisbury and Swindon, let alone the smaller ones in Chippenham and Frome.

Andy Milroy, who led a campaign against the closure of the beds at Trowbridge, said it would mean mothers having less choice and having to travel further to give birth.

Speaking today, he said: “It is going to lead to heavily pregnant women who are about to give birth being left without a midwife and giving birth in taxis or at home because they can’t get to hospital in time.

“This is a large area. It is bigger than Gloucestershire. People in Trowbridge will have to travel to Chippenham or Frome and beyond.

“The problem of babies being born in laybys is going to increase.”

Dianne Davis, 44, from Bromham, whose youngest daughter Gracie, now 11, was the first baby to be born when the new-look Trowbridge birthing unit opened in 2009, said she was “devastated” by the decision.

She added: “No! I also heard they are opening a birthing centre in Salisbury! If it’s a good idea for Salisbury why not west Wiltshire?

“Devastating news. Less choice for parents with regards to birthing choices and less support following birth and more and more pressure on the larger hospitals like Bath and Swindon that are already struggling to cope - a very sad day.”

Mr Milroy was speaking after health bosses decided today to close the birthing unit beds in Trowbridge and Paulton from April this year, as part of a transformation of maternity services across Bath, Swindon and Wiltshire.

They unanimously approved six recommendations at a Clinical Commissioning Group Governing Bodies meeting at Dorothy House Hospice Care in Winsley.

It means pregnant women will now have to go to hospitals in Bath, Swindon and Salisbury to give birth or to Chippenham where three beds are being kept for birthing.

Two 'free-standing maternity units' in Chippenham and Frome will continue to provide beds for birthing.

All four maternity units, Chippenham, Trowbridge, Frome and Paulton, will continue to provide antenatal and postnatal services.

The bosses decided to replace four postnatal beds at Chippenham with increased support for women closer to or at their homes.

In addition, the meeting approved plans to create 'Alongside Midwifery Units' at Salisbury District Hospital and at the Royal United Hospital in Bath, and to improve the antenatal and postnatal care there.

Lastly, the CCG will 'improve and better promote its home birth services'.

Lucy Baker, acting director for maternity services at Wiltshire CCG, said that in December only four babies were born in Trowbridge and only six in Paulton.

Across Bath and North East Somerset, Swindon and Wiltshire, there were 11,200 births last year.

She added: “The decision follows a three-year period of engagement and consultation with more than 4,000 mums, families, staff and partners in the community to develop a new vision for maternity services, proposals for change and final recommendations.

“Our proposal would allow us to provide more choice for more women across our area about where and how they are supported before, during and after the birth of their baby, and allows us to make more efficient use of our resources and workforce so we can further improve our antenatal and postnatal and birthing services.

“We also want to ensure we are delivering the services that can meet the changing needs of our local women and families both now and in the future.”

She said that over 83 per cent of the female population in the three areas was within 30 minutes of a birthing unit in terms of travel time.

She told the meeting the CCG had changed its strategy following public consultation to phase in the replacement of four postnatal beds at Chippenham over the next 12 months, while it works with mothers and families to support home births.

Sarah Merritt, acting deputy director of nursing and midwifery at the Royal United Hospitals Bath NHS Foundation Trust, said: “These proposals will help us provide more choices for birth to more women and will build a strong foundation on which to enhance continuity of care so that more women can see the same midwife or small team of midwives before, during and after labour.

“The addition of Alongside Midwifery Units at the Royal United Hospital in Bath and at Salisbury Hospital will give our birthing mums a new option for labour and delivery, significantly enhancing choices in Salisbury in particular.

“Our midwives and staff are excited to embrace this new way of working in purpose-built facilities.”

The CCG hopes to have the new AMU at Salisbury open by 2021 and the one at the RUH in Bath open by the end of 2023.

It will now launch a new Room to Grow appeal to fund the new AMU at the RUH at a cost of just over £6.17 million and will submit bids for government funding.

The RUH is encouraging mothers to put forward ideas to co-design a new community postnatal offer that will meet the needs of local people.

Mr Milroy said this would lead a “gap in provision” between the Trowbridge birthing beds being closed and the RUH being able to open its new facility.

He has accused the "unaccountable" CCG Governing Bodies of ignoring the results of its own consultation, which indicated that 62 per cent of respondents wanted the Trowbridge unit to stay open.

Mrs Baker rejected the criticism, saying only 55 of the 88 people (62 per cent) who responded to the Trowbridge proposals had asked for the unit to stay open.

She told the meeting the decision addresses the issues posed by changes to the population and the need to respond to the government’s better birthing recommendations.

She said: “The average age of a woman giving birth in the UK is now 35 and more and more women are experiencing high risk pregnancies because they are leaving it longer before they choose to have a baby.”

She said this is leading to an increase in complications, such as high blood pressure, obesity or diabetes, which means they need to be supported in an obstetric hospital setting with an expert medical team available.

The combination of these factors means there is vastly increased pressure on services at the Obstetric Units at the RUH, the Great Western Hospital and at Salisbury District Hospital, she said.

In addition, many women with a low-risk pregnancy are choosing to have their babies in an Obstetric Unit because they are worried about having to be transferred by ambulance to another site during or after their labour if they need the help of a doctor.

The CCG said that women need a safe, convenient alternative so staff at the three obstetric units at Bath, Salisbury and Swindon hospitals can focus on mothers who really need their care.

Mrs Merritt told the meeting: “Some of the changes we are proposing are because, particularly at the RUH, certain services are under-used and we are often staffing empty buildings and beds.

“85 per cent of women give birth in one of the three Obstetric Units with fewer than six per cent giving birth across our four FMUs in Chippenham, Trowbridge, Paulton and Frome.

“We believe we have the right number and mix of staff but they’re not based in the right locations to ensure efficient use of our resources and provide women with the services they need.

“In our FMUs - particularly at night - staff are covering areas even when there are no or very few births.

“On average only one baby is delivered every two or three days in each of these units but they need to be staffed to support births 24 hours a day seven days a week.”

They said plans have been developed to ensure services are efficient and sustainable to support future population growth, changes in housing policy, and the repatriation of military personnel to South Wiltshire.

Ruth Grabham, medical director for Bath and North East Somerset CCG and a governing body member, said: “While services will be changing, it is important to note that approval of the proposal will not result in the closure of any buildings or reductions in budget and staffing for maternity services.

“Maternity services will remain available at all four FMUs antenatal and postnatal care will continue to be provided at these sites.”

Chaya Tagore, Maternity Voices Partnership Lead and one of the members of the Expert Panel that reviewed the consultation results and developed the final recommendations, said: “It’s really important that all women across Bath and North East Somerset, Swindon and Wiltshire have easy access to maternity services and this proposal means more choice to more women about where to have their baby. I encourage expectant parents and those who have used maternity services in the last five years to get involved with the MVP.

“The next steps as new community hubs are developed, where women can access integrated care from pre-conception to postnatal care are wonderful opportunities for co-creation. As MVP Volunteers we are really excited about enhanced support for home births and ongoing care.”