Plans to reinstate Jersey’s home birth service remain uncertain as health leaders warn that safety must come before political pressure to set a reopening date.

Express revealed that Jersey’s home birth service had been paused in October 2024 amid concerns about staff numbers and training.

At the end of last year, Assistant Health Minister Andy Howell confirmed that the provision would remain suspended after the death of a mother and baby in Manchester raised concerns about the lack of national guidance on home births.

A prevention of future deaths report, issued by a senior coroner in Manchester, highlighted a lack of national guidance for home births and the risks associated with high-risk pregnancies being managed at home without a robust framework.

During a Scrutiny hearing this week, nursing and midwifery lead Cathy Stone provided an update on the situation in Jersey on behalf of the Chief Nurse.

She explained that the failings highlighted in the UK report aligned with Jersey’s position in 2024, when the home birth service was paused.

“We knew at that time we had a lack of staff with those clinical competencies,” she explained.

Ms Stone stressed that a “significant cohort” of experienced midwives was needed for any “switch-on, switch-off” home birth service – and Jersey did not have that cohort.

“I’m a very old midwife,” she said. “I’ve undertaken a lot of home deliveries. I know what we’re talking about, but a lot of our newly qualified midwives do not have that portfolio of experience.

“When you’re working in the community with that level of risk assessment and how you deal in autonomy, you need that level of experience. That is what is key.”

However, she said that a “very, very good training programme” had been developed. As of the hearing, about 85% of midwives had achieved the required skill level to handle home births.

Work is also under way with the ambulance service to ensure proper paramedic support and clear emergency pathways, reflecting another weakness identified in the Manchester report.

Jersey is also involved in UK work to produce clear, evidence‑based guidelines – including standards, staffing levels, competencies, and governance – for home births, but the report expected in January has been delayed.

During the hearing, Health Minister Tom Binet raised concerns about what he described as a “pressure for dates”.

“I think what’s been made very clear this afternoon is that this has to be and will continue to be driven by safety considerations,” he said. “Safety has to be the principal consideration.”

Health and Social Security Scrutiny Panel chair Deputy Louise Doublet pressed for clarity on whether the ultimate aim was to reinstate a home birth service.

Ms Stone explained that the aim is to have all the facilities, training and safety measures in place so that a safe, effective, responsive home birth service could operate.

Once those are in place, a decision will be made on whether to reinstate the service, she said.

Deputy Binet added that if, after the review, the service could be safely provided within existing resources, it may be reinstated.

But the minister emphasised that if safe provision requires additional staff or resources, that costed choice will have to be brought back and weighed against other health priorities.

“The clinical decision comes first, and the political has to follow,” he explained. “What does the public want? How much tax do we charge people? Where do we put our priorities?

“It may well be that once the analysis is done, it does allow for the service to open – but those decisions will be made on a political level.”