Green Maternity Challenge 2024
As part of CSH’s larger project ‘Taking collective action to deliver low carbon, equitable maternity care’, The Green Maternity Challenge was delivered by CSH in partnership The Royal College of Obstetricians and Gynaecologists (RCOG), The Royal College of Midwives (RCM) and The Sustainable Healthcare Coalition (SHC).
This work was commissioned and funded by SBRI healthcare as an Accelerated Access Collaborative (AAC) initiative, in partnership with the Health Innovation Network. The views expressed in the publication are those of the author(s) and not necessarily those of SBRI Healthcare or its stakeholders.
What is the Green Maternity Challenge?
The Green Maternity Challenge is a maternity focused project based on CSH’s groundbreaking Green Specialty Challenge.
In the Green Maternity Challenge, nine clinical teams in the UK were selected to receive training and mentoring from CSH to develop, plan, run, and measure the impact of a sustainable quality improvement (SusQI) project. Projects will focus on identified target areas for reducing environmental harm and health inequalities.
About maternity care
Maternity services account for a significant portion of the NHS’s carbon footprint, contributing to the UK’s environmental crisis. With over 673,000 births in 2022, the impact of NHS services on the environment is substantial. Pregnant women and infants are particularly vulnerable to climate change, which exacerbates health complications. Furthermore, significant health inequalities persist, disproportionately affecting women from ethnic minorities and disadvantaged backgrounds. Addressing both the environmental impact and healthcare inequalities is crucial to improving outcomes and creating a more sustainable, equitable healthcare system.
What was the impact?
In the Green Maternity Challenge, CSH helped nine clinical teams in NHS trusts across the UK make a huge positive impact on sustainable and equitable maternity care.
The impact of this challenge has been significant, with projected annual cost and efficiency savings of £860,669. The projected carbon savings are 101,263 kgCO2e, equivalent to 778,978 disposable nappies.
Green Maternity Challenge launch event
The Green Maternity Challenge officially launched in June 2024, bringing together those working in maternity care services as well as members of the public with lived experience or an interest in sustainability in maternity care.
“Now is your time to point the way to a brighter future. It will be your ideas, collaborative working and innovative mindsets that will lay the path for all delivering maternity care to follow. Do not hold back, come together and submit your ideas and we will support you every step of the way to demonstrate how these ideas can achieve the change that is so evidently required.”
Dr Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists (RCOG)
Watch the recording below to learn more about the challenge, the carbon and equity target areas, and how teams were supported to drive change.
The starting points for change
At the beginning of the project, we identified a set of target areas to guide improvement efforts. These areas reflected the most pressing challenges in maternity care and were chosen to help make services more equitable and sustainable. Because the areas often overlapped, many teams found themselves working across several at once. Throughout this work, the focus remained on the outcomes and experiences of people using the services, with particular attention to those who are currently underserved by the status quo.
The teams
We were delighted by both the number of applications received and the quality of project ideas submitted. While the Green Maternity Challenge originally aimed to support six teams, the generosity of our sponsors enabled us to expand this to nine.
The Green Maternity Showcase
On 5 March 2025, we held the Green Maternity Showcase — a celebration of the nine project teams who took part in the Green Maternity Challenge, all committed to creating more sustainable and equitable maternity care.
Each clinical team presented their Sustainable Quality Improvement (SusQI) projects to a judging panel. The projects focused on the key target areas identified through collaboration with challenge partners, carbon footprinting analysis, and lived experience input: valuing people’s time, supporting informed choices, listening to women, improving access and experience for those with the worst outcomes, complex pregnancies, infant feeding, and pelvic health and continence. All projects shared a common goal: reducing environmental harm while tackling health inequalities in maternity services.
Winning team
Winner: Norfolk and Norwich University Hospitals NHS Foundation Trust — recognised for improving care for women with hyperemesis gravidarum, reducing hospital admissions and saving 6,462 kgCO₂e annually.
Highly Commended: NHS Orkney — for their innovative approach to rural hip dysplasia screening.
Highly Commended: Imperial College Healthcare NHS Trust — for developing streamlined antenatal care pathways.
Showcase outcomes and learning
The Green Maternity Showcase celebrated the inspiring work of the nine project teams who took part in the Green Maternity Challenge. Together, these teams are helping to shape more sustainable and equitable maternity care.
During the event, each clinical team presented their Sustainable Quality Improvement (SusQI) projects. These focused on priority areas identified through collaboration with challenge partners, carbon footprinting analysis, and discussions with a lived experience group.
To see all the video presentations from the showcase and case studies reports from each team project, please head to our dedicated page below.
“There is so much good work happening that we don’t usually hear about, and it was a privilege to witness such amazing projects today. I was pleased to see so many people involved and look forward to further collaboration with hospitals, trusts, and teams. I hope this challenge inspires more initiatives like it.”
Dr Frances Mortimer, medical director, Centre of Sustainable Healthcare
Why we needed a green maternity challenge
Maternity services are among the highest-volume areas of the NHS, with over 673,000 births in the UK in 2022. Each birth is usually preceded by around 30 weeks of antenatal care and followed by postnatal support, making maternity a major part of NHS activity.
The NHS is responsible for around 4% of the UK’s carbon footprint – equivalent to the entire annual emissions of Croatia. This means NHS services, including maternity care, are directly contributing to the environmental and ecological crisis. At the same time, pregnant women and infants are particularly vulnerable to the health effects of climate change, such as extreme heat, poor air quality, and natural disasters. These risks can lead to complications such as preterm birth, low birth weight, and respiratory problems.
Inequalities within maternity services persist across the UK, disproportionately affecting women and birthing people from ethnic minority and socio-economically disadvantaged backgrounds. Black women are four times more likely to die during pregnancy or childbirth compared to white women, and Asian women face twice the risk. Women from the most deprived areas are also more likely to experience stillbirth compared to those from the least deprived.
Climate change and healthcare inequalities are deeply interconnected. Disadvantaged communities are often more exposed to environmental hazards, less able to recover from them, and have reduced access to high-quality healthcare. Together, these factors compound and worsen existing health disparities.
By addressing both inequalities and environmental harm within maternity services, we can improve health outcomes and experiences of care while contributing to a fairer and more sustainable healthcare system.
Key dates and activities
This challenge was open to everyone — both those working in maternity care services and members of the public with lived experience or an interest in sustainability in maternity care.
Application and selection
- 24 July 2024 – Applications opened
- 20 September 2024 – Applications closed and shortlisting began
- 30 September 2024 – Successful teams contacted
Workshops and project launch
14–18 October 2024 – Project launch workshops
Teams joined a 90-minute virtual workshop covering sustainable healthcare, the SusQI methodology, and project development.
Project phase (14 October 2024 – 31 January 2025)
Over 12 weeks, teams:
- Set aims and planned improvements
- Implemented changes in practice
- Collected data to measure outcomes
- Calculated the impact of their changes
- Received support from the CSH environmental analyst team, including carbon footprinting of project outcomes
Reporting
Each team submitted a SusQI Project Report, reviewed and supported by the CSH team
Showcase event
Teams presented their projects to a judging panel and live audience on 5 March 2025.
The judging panel included:
- Dr Ranee Thakar, President of RCOG
- Fiona Gibb, Director, Professional Midwifery, RCM
- Emma Crookes, Lived Experience Representative
- Dr Frances Mortimer, Medical Director, CSH
There is still more you can do
The Green Maternity Challenge has already had a significant impact, delivering an estimated £860,669 in annual cost and efficiency savings and reducing emissions by 101,263 kgCO₂e each year — the equivalent of almost 779,000 disposable nappies.
But the work doesn’t stop here.
We invite you to join the CSH Women’s Health Network — an online community of healthcare professionals dedicated to reducing the environmental impact of women’s health by sharing knowledge, ideas, and examples of good practice.
You can also explore the Maternity Challenge case studies in our resource library, alongside a wide range of other research, resources, and case studies focused on women’s health and sustainability.
Please contact Rachel McLean, CSH’s SusQI programme lead if you have any questions about the project.