There are no hospitals/birth centre near me that have a ‘good’ or ‘outstanding’ CQC rating for maternity services

[58ESY58]

I recently found out I am pregnant with my second child, due in June 2026 but can’t find any hospitals within a 20 mile radius from me with a ‘good’ or ‘outstanding’ CQC rating - all are ‘required improvement’ or ‘inadequate’ for maternity services.

I gave birth to my first child in April 2024 at Queen Charlotte Hospital, even though it was approx 1hr drive each way from where I live in Cheshunt, Hertfordshire. I didn’t mind the journey for appointments as it was one of the highest rated hospitals and I knew I would be getting good quality care. I had a really positive birth experience so naturally I wanted to refer myself there again for this pregnancy.

However, there is a new ‘rule’ in place with a lot of London hospitals (might be elsewhere too) where they are only accepting referrals from people within a catchment area (which I am not). I have now tried Queen Charlotte, UCLH and Homerton but no luck. I was told I need to look for a hospital close to where I live as they are getting too many referrals hence the introduction of the catchment area.

What makes it harder is I would have preferred a birth centre birth, but at this rate I’d be thankful just to have a good hospital. I’m not sure what to do now. Im 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 an ethnic minority.

Any suggestions/advice? I’m feeling very hopeless!

Sometimes you have to pick the lesser of two evils so to speak.
I personally gave birth in a unit that was rated inadequate and was undergoing a lot of investigations for child deaths. It was however, the best maternity care I had recieved compared to my experience in a different unit that only 'required improvements' just a year and a half prior. I had no choice in either unit as they were the only ones available to me.

I think if you're aware of your risks being a minority, it's something that perhaps you need to make sure there are extra things in place. Ie, asking more questions and being kept informed regarding certain practises or details of your care. For example, how much blood you're actually losing, what your blood tests are actually testing for and asking for ones you know you may be at risk of more...
And if the units you have available to you really dont tickle your fancy, you may have to consider alternatives such as, going further out or a home birth

If you can afford it I highly recommend getting an independent midwife. IME the care I got from mine was worlds away from anything I got from the NHS.

I gave birth nearly a month ago in a hospital that ‘requires improvement’ and the care I received was amazing compared to when I gave birth in a different hospital in 2022 (rated good at the time but now also rated as requires improvement). I also gave birth in September which is meant to be the busiest time of year, but I wouldn’t have known it.

I was anxious because my first birth was traumatic- but I looked at the report and spoke to the hospital about my concerns. They were rated that way because of staffing levels - but they reassured me about all the steps they had taken to resolve that (to the extent there was now a recruitment freeze and no student midwives were being given jobs). I had my own midwife, my own room
and my consultant made sure I was booked in with her for my c-section. They went over and beyond. When I told her afterwards how positive it had been she said that’s why people shouldn’t just believe what they read.

I know it’s not what you want but I wouldn’t rule them out just on that basis alone - you can still have a good experience. Communicate your concerns and see what they say!

Would you consider a home birth?

If you can afford it, I would suggest going private.

I would maybe look into the reports for the nearest hospitals and look at the problems highlighted that is the reason for the inadequate or needs improving status and also look for personal experiences for those hospitals

The hospital I have had 2 children in has been rated as requiring improvement.
When I had my daughter in 2020 I gave birth in the midwife led unit the pool was run whilst I was making my way to the hospital. It was a 20 minutes drive and she gave me a quick exam. I was surprisingly 10 cm already having only been 2cm 1.5 h earlier. I got straight into the pool and gave birth with gas and air half an hour after getting to the hospital.

With my second I was in and out for hospital from 29 weeks after developing a range of pregnancy complications. I was attending at least twice a week for bloods tests and monitoring. I attended at 34 weeks in threatened preterm labour, had an admission at 35 weeks due to extreme fatigue, another admission at 36 weeks for further investigation of the fatigue. Then I was brought in for induction at 36+6. I was well looked after, there were a few issues mostly around access to doctors as you switch from the day to night shift. This was most pronounced in pregnancy when I could only be discharged by registrar or higher.
I had 2 midwives with me through out my labour, at one point there were 4 midwives whilst baby was in distress and had 3 with me at birth.

After both births I had a single room where my partner could spend the night if needed as per my birth plan due to a health condition that's made worse with lack of sleep.

I can not fault the care I had from the obstetrician. She looked into some unusual family history I had for risk of blood clots and checked with colleagues about action. She ensured that there was a named Dr waiting for blood results if she wasn't on shift. The day I was brought in to be induced she phoned to check my results despite it being her day off. When I was the in labour she contacted other professionals involved in my care for my other condition again on her day off. She personally came to check on me when she was back on shift after the birth even though the resident Dr had discharged me from obstetric care the day before.

After care has been good too, they identify a tongue tie at birth and they did the referral to the infant feeding team on day 1 they contacted us on day 7 and I had an appointment on day 8 with the tongue tie cut at the same time.

The hardest part of my second pregnancy was being apart from my daughter. It was hard enough with the frequent trips for blood tests and waiting with a 20-30 minute journey. I'm not sure I'd want an hour journey. If I had had an hour journey with my daughter she would have been born at the side of the road !

Thanks for sharing your story, really helpful!

Do look at the reasons why! Sometimes it’s more administrative than medical

Thanks for the advice!

When were the inspections from? I gave birth at a requires improvement hospital but not long after it was rated as good and I was happy with my care there. You could also read the reports and see in what areas they were marked down on to see where the score comes from.

I had a longish thread last year about giving birth at St Georges, which is also inadequate. I had a great birth there. Have you read the specifics of each CQC report? I basically asked Georges what they were doing about the report, they had the deputy director for midwifery ring me and explain what they were putting in place to address and basically gave me lots of reassurance. It wasnt all totally plain sailing but DH and I felt confident enough at that point to advocate for ourselves (it was our second DC). Depending on funds, you could look for a doula or independent midwives to be alongside you and advocate.