2026

Disputed (AI summary) • On 26 November 2025, NHS England wrote to all NHS maternity providers in England asking them to urgently review the safety and quality of their homebirth services. • NHS England urged them to consider issues such as the operational running of their service and care planning and risk assessment. • NICE stated that home birth is covered in its guideline on intrapartum care (NG235). • The guideline covers eligibility, informed choice, and midwife support for home births. • The guideline includes recommendations that support further discussion with an appropriately trained senior or consultant midwife and/or a senior or consultant obstetrician (if there are obstetric issues) if such a discussion is wanted. • Officials made enquiries with NHS England to address the coroner's concerns. • NHS England will be issuing a substantive response addressing the specific matters of concern raised. • NHS England is asking for an urgent review of the safety and quality of homebirth services. • The review should consider the operational running of the service, care planning and risk assessment, and governance and oversight.

Disputed (AI summary) NICE acknowledged the concerns but stated that the registration, regulation, and training of doulas are not their responsibility and are better addressed by other bodies such as the NMC, RCM, and RCOG. Developing Doulas submitted a voluntary response, disputing the perception that the doula's presence negatively impacted midwifery services. They argued that the doula acted within a non-clinical support role and that difficulties highlight the need for strengthening communication and collaborative working with non-clinical supporters. The Department of Health and Social Care acknowledged concerns about unregulated doulas, clarified their current status as non-regulated professionals, and outlined the roles of other bodies like the NMC and NICE. They stated that NHS England will not be producing guidance for midwives' interactions with doulas. The NMC has updated its guidance and collaborated with Doula UK to launch a video resource clarifying the distinct roles of midwives and doulas to support positive maternity experiences. They stated that doula registration, regulation, and training are beyond their remit and a matter for government policy.