Gaps in staffing levels are behind concerns about home birth safety, according to a national safety review.

The review, published by the Maternity and Newborn Safety Investigations (MNSI) programme, raised concerns about whether trusts have sufficient staffing levels, the appropriate skill mix and the right processes in place to provide safe cover for home birth services.

The RCM's director of midwifery, Fiona Gibb, said: ‘This report is a stark reminder of the consequences when maternity services are not staffed safely. Midwives want to provide the highest standard of care, but they need the time, resources and support to maintain their skills and meet the needs of the women and families they care for.

‘Alongside the recent NHS England review and learning from coroners' cases, this report must act as a catalyst for change. Maternity services across the UK need the investment and support required to ensure women can make genuinely informed choices about their births and that midwives are able to provide safe, high-quality care in every setting.'

The review found some trusts did not provide sufficient training or opportunities for midwives to build and maintain experience in midwifery-led care in home settings, which could affect confidence in recognising and managing complications. In addition, the review found delays in recognising when a mother or baby needed to transfer from home to hospital.

The report highlighted eight areas for trusts to review when considering their home birth services: service provision, including staffing availability and the provision of guidance and training standards for midwives attending home births; communication and escalation; risk assessments; heart rate monitoring; recognition of evolving emergencies; care delivered outside guidelines; ambulance transfers; and internal environment, including factors within the home such as lighting or the positioning of a birthing pool.

An NHS England spokesperson said: ‘Women should be able to have confidence that they will receive safe, high-quality and equitable maternity care wherever they choose to give birth.

‘We welcome the findings of the report, which will help us continue to improve services. As part of our 10-point plan to improve maternity care, we have already asked trusts to rapidly review the safety and quality of their home birth services, including staffing, training and escalation.

‘We are also developing national standards for home birth services to support consistently safe care across the country.'

A Department of Health and Social Care spokesperson said: ‘Every woman deserves the right to give birth safely, regardless of whether this is at home or in hospital, and we welcome the MSNI's report and the concerns they have raised.

‘We are currently working together with NHS England to develop standards for home birth services in England and producing national guidance to provide safe and respectful care for women who choose to give birth outside of clinical guidance.'