Top hospitals turn away pregnant women too scared to use local units

The Observer understands the surge in demand is because women are travelling outside their area to attend maternity units with better care ratings. Only 4% of England’s maternity units are rated “outstanding” by the Care Quality Commission (CQC), the independent regulator, while almost half are rated “requires improvement” or “inadequate”. Over the past year a series of scandals, inquiries and investigations have uncovered serious failings in maternity units across the country.

In February 2025, London’s Imperial College healthcare NHS trust, which was rated outstanding for its two maternity units in 2023, announced it had made the “difficult decision” to temporarily limit self-referrals for pregnant women from outside the area. The trust said that the number of deliveries at its maternity units by women who lived outside north-west London had increased by 15% between 2019 and 2024.

“We have to ensure we can continue to provide high-quality care, including for those with complex pregnancies or births, many of whom are from lower socio-economic and Black, Asian and minority ethnic backgrounds who we know face some of the biggest health inequalities,” said Susan Barry, the director of midwifery at Imperial College healthcare NHS trust.

Since 1 June 2025, east London’s Homerton healthcare foundation trust said it was temporarily capping new maternity bookings owing to a “steady rise in out-of-area maternity bookings, which now make up 40% of our total births”.

Other trusts, which have publicly said they are limiting referrals as a result of increased demand and safety concerns, include the Chelsea and Westminster hospital trust, South Warwickshire University trust and the Royal Surrey County hospital trust.

Last week, one Mumsnet user reported being turned away by several maternity units in London after failing to find any hospitals rated “good” or “outstanding” near their home in Hertfordshire. “I’m finding it difficult to refer myself to a hospital that I know is rated inadequate, as I don’t feel confident in the care I might receive, especially being [from] an ethnic minority,” they wrote.

Justine Roberts, the founder of Mumsnet, said: “Repeated scandals and damning reports into maternity care are creating huge anxiety for pregnant women before they even set foot in hospital.

“As conversations on Mumsnet show, some women are so worried about local services that they feel forced to travel elsewhere. This postcode lottery is simply not acceptable. Women should be able to feel confident that they can access safe, high-quality maternity services close to home.”

Sarah (not her real name) moved from Nottingham to Cardiff last year because she did not feel comfortable giving birth at her local hospital. “I would be going in for my checkups, and they would be playing the radio while I was having my observations done. I would be [reading] things like ‘Nottingham University hospital[s NHS] trust being taken to court for corporate manslaughter over deaths of babies’,” she said.

Nottingham University hospitals NHS trust is currently subject to the largest inquiry into maternity care in NHS history, with more than 2,500 cases being examined, alongside a continuing police probe into potential corporate manslaughter. “That was really, really difficult because you have to have an element of faith in the people taking care of you, and that was really hard to do… to find that trust,” Sarah said.

Dr Toli Onon, the CQC’s chief inspector of hospitals, said that while there were many maternity services providing good care, the safety of maternity services remained a concern at a national level. “Our assessments continue to find serious inequalities, unwarranted variation, and maternity units where standards of care are falling short.”

A Department of Health and Social Care spokesperson said: “This government inherited a maternity service in crisis and we’re working at pace to ensure women receive the care they deserve.”

Photograph by Getty