Improving access to home birth and midwifery unit birth settings is a national priority, with the National Institute for Health and Care Excellence (NICE) (2023) supporting home birth as a safe option for low-risk women. However, birth place discussions continue to vary, influenced by midwives’ confidence, organisational clarity and service pressures. Following a national evaluation published in MIDIRS Midwifery Digest (Todd 2025), in which midwives identified training and confidence-building as one of the top priorities for increasing home birth uptake, a large NHS trust implemented the Strengthening Place of Birth Project. This initiative aimed to improve midwives’ confidence, ensure consistent birth place discussions and enhance access to all birth settings.

The project combined mandatory training, practical tools, place of birth champions, and targeted cultural change. Evaluation across two surveys (n = 66) demonstrated increased midwife confidence, improved understanding of eligibility, increased home-birth referrals, and a 118-birth rise in midwifery unit usage. Reflective vignettes from Place of Birth Leads highlight the practical changes experienced across teams. This article outlines the project’s development, evaluation and early impact, demonstrating a replicable, midwife-led approach for strengthening personalised birth place conversations in NHS maternity services.