PURPOSE:
To present the work of a national collaboration of midwives, obstetricians, academics, maternity care supporters, service users who aim to address the growing crisis in UK maternity services. The collaborative aims to analyse contributing factors, share clinical insights and lived experience, and co-design strategies to promote respectful, evidence-based care.

DISCUSSION:
The rate of caesarean sections in England has surged to 44%, up from 29% in 2018, while inductions of labour now occur in over one-third of pregnancies. Despite this escalation in intervention, maternal mortality is rising. Falls in stillbirth and neonatal mortality rates are well below the expected trajectory, and disparities due to inequalities persist. Alongside these trends, more women report traumatic birth experiences, and both litigation and freebirth are rising, indicating a growing lack of trust in formal maternity systems. Simultaneously, access to midwife-led and out-of-hospital birth options continue to diminish. International comparisons highlight that countries with lower intervention rates often achieve better perinatal outcomes, underscoring the need for systemic reform in the UK.

EVIDENCE WHERE RELEVANT:
This initiative is grounded in established evidence that continuity of midwifery care and midwife-led care provided in respectful collaboration with medical and other staff where needed, improves outcomes, reduces intervention rates, and enhances satisfaction. UK and global evidence to be discussed will include: Scarf 2018, Coxon et al 2021, MBRRACE-UK, 2022; Birth Trauma Association 2023, NHS Digital 2023, WHO 2024.

KEY MESSAGE:
The current UK approach to maternity care has not translated into sufficiently improved outcomes and is contributing to trauma, litigation expense, and reduced trust. A multidisciplinary, evidence-informed response was needed to begin to address these trends and reinstate collaborative midwifery focused, person-centred care as a foundation of safe and respectful maternity services. As global concern increases about rising rates of intervention and disrespectful maternity care, our initiative might help others to consider a collaborative midwifery solution. Interprofessional - collaboration