The ongoing discussion regarding the location of maternity services in Liverpool

Liverpool Women’s Hospital, a specialist facility that has delivered many of the city’s babies for 29 years, is highly regarded. This institution functions as a significant research hub, addressing all facets of women’s health, from delivery to menopause. It holds the distinction of being the largest hospital of its kind in Europe and the sole one in England. However, its geographical placement and its status as an isolated facility have been recognized as a significant concern for an extended period. Jo Kennedy, a midwife who has served at the hospital for ten years, noted that numerous staff members have given birth to their own children there and express pride in their workplace. She stated, “It’s a fabulous place to work. Childbirth is a really positive experience and we try to empower women to have the birth experience that they want. We have a really dedicated team who provide really high-level care.” Nevertheless, Ms. Kennedy also acknowledges the disadvantages associated with the hospital’s site and amenities. A significant issue is the absence of critical care units at the hospital. Consequently, in cases of severe complications, patients must be urgently transported by ambulance, a process known as “blue lighting,” to one of the city’s two acute hospitals, typically the Royal Liverpool, or sometimes Aintree. Emma Gregson, a sister in the critical care unit at the Royal Liverpool, has provided care for multiple women following such transfers. Despite the Royal Liverpool being only 1.3 miles (2km) from Liverpool Women’s, she indicated that the necessity of moving between facilities can profoundly affect patients. She remarked, “Certainly if they are an awake patient, it’s really traumatic. I can’t imagine what that must feel after you’ve gone through – whether that be an operation or childbirth- and have to then come in an ambulance and be transferred over.” Furthermore, since the Royal Liverpool lacks a neonatal unit, if a mother is transferred there post-delivery, her infant must remain at Liverpool Women’s. Ms. Gregson highlighted that this situation deprives families of crucial bonding time immediately after birth. She added, “And then the poor dad of the baby doesn’t know what to do or where to be – whether to go there or whether to come here and support each of them. It’s a really traumatic time. Really awful.” Annually, approximately 220 women, averaging about four per week, are transported by ambulance between Liverpool Women’s Hospital and other primary hospitals within the city. Roughly half of these transfers constitute emergency situations, a factor that is fueling the current discussion regarding the future of Liverpool’s maternity services. The absence of maternity provisions at the Royal and Aintree hospitals also signifies that pregnant individuals admitted for unrelated health conditions do not receive pregnancy-specific support. Dr. Oliver Zuzan, the medical director for the Royal Liverpool, commented: “If you are pregnant and you develop a headache or a tummy pain, where do you go? You normally go to your emergency department and that’s absolutely fine….but we have no support for the pregnancy side of it. We can do everything else apart from dealing with the pregnancy.” Ms. Kennedy, who specializes in critical care and outreach, regularly travels from her primary location at Liverpool Women’s to the Royal Liverpool and Aintree. Her role involves visiting pregnant women who have been admitted to these hospitals for non-pregnancy-related ailments. She explained, “The problem is that the staff at these sites aren’t trained midwives. They are nurses so they don’t know how to monitor for the pregnancy or foetal concerns. So if the woman reports an issue with the baby – say she has reduced foetal movements, we have to consider is she better looked after on that site or should we bring her over to the Women’s? If we bring her back over here, we might not have specialists [to treat] whatever she’s been admitted for.” Hospital administrators in the city have indicated that modifications are long overdue and are currently assessing the optimal delivery of maternity services. However, these discussions have encountered considerable opposition from certain segments of the public, evidenced by a petition against any proposed alterations that has garnered 75,000 signatures. Annually, over 7,500 women deliver babies at Liverpool Women’s Hospital. Opponents of change emphasize that the overwhelming majority of these women remain at the facility, which was constructed specifically for and is exclusively dedicated to their care. Lesley Mahmood, a co-founder of the “Save Liverpool Women’s Hospital” campaign, established in 2015 during a previous review of maternity service reorganization plans, commented: “It’s a beautiful site. It’s quiet, it’s very tranquil, it’s low rise…many women don’t want the chaos of a general hospital. The women generally feel that it’s a very, very safe place for them to go to, and they value that highly.” Ms. Mahmood further highlighted that the specialized gynaecology emergency department at Liverpool Women’s boasts a significantly quicker treatment rate and a more serene environment compared to most general hospitals. She expressed apprehension that any restructuring might result in its integration into the Royal Liverpool’s emergency department, which manages a comprehensive array of medical emergencies. Protesters contend that a prior proposal from 2017, which aimed to relocate women’s services from the women’s hospital to an adjacent site near the Royal Liverpool, is merely being revived. This plan was previously halted due to a lack of funding from central government. Rebecca Smyth, a former midwife at the Women’s Hospital and an active participant in the campaign opposing any changes to maternity services in Liverpool, stated: “Millions have been spent [at Liverpool Women’s], £15m just recently on a new neonatal unit. They have new MRI scans, CT scans, good haematology, good colonoscopy, why would you want to close a hospital where you’ve spent so much money and effort into making it state of the art?” The Cheshire and Merseyside Integrated Care Board (ICB), the body responsible for healthcare administration in the region, firmly refuted claims that any plans were underway to close the hospital. The ICB affirmed that no definitive decisions had been reached regarding the optimal path forward and that they remained receptive to various possibilities, but explicitly stated that the closure of Liverpool Women’s Hospital was not under consideration. Furthermore, campaigners expressed dissatisfaction with the public engagement initiative, which commenced in early October to gather opinions on the future direction of maternity services in Liverpool. Teresa Williamson-Akpan raised concerns about the requirement for advance booking for public meetings. She recounted, “I went on the first Teams one and there were only seven of us on it and four of us were from the campaign. To have a miniscule number of people turning up is concerning, because that’s not representative.” The ICB clarified that these meetings constituted only one component of their comprehensive research efforts, which also involved soliciting feedback from community organizations, employees, and past patients. They further noted that several hundred individuals had completed the online survey. The discussion concerning the optimal structure of maternity services in the city has intensified significantly since the initial consultation nine years prior. In Liverpool, mirroring global trends, the average age of mothers is rising. Projections indicate a decline in women’s health, while medical advancements now enable some women who previously could not conceive to have children. All these factors point to a greater need for care, yet the method for best delivering this care remains unresolved. The public engagement initiative is scheduled to conclude on 26 November. Individuals wishing to submit their perspectives can complete a questionnaire available on