We have written this book because the story it tells warrants a wide audience. We see the purpose of this book as informing discussion and decision-making around reconfigurations of maternity care, so that planning, communication, management and recruitment can be improved and shared vision articulated and understood.A" Throughout the world, women-centred care is gaining prominence in providing maternity care. Many birth centres open each year to meet this need - but at the same time, many close or are shelved. So why should the turnover in organisations that deliver such a vital service to women be so high, thwarting many midwives from practising as they would wish? This carefully researched and passionate book tells the story of a birth centre that did fail, and the painful but valuable lessons it presents for others. Many of the issues and behaviours illustrated - lack of leadership, support, vision and plain-dealing, and tensions between bureaucracy and women-centred care - will find resonance in maternity services and midwifery experiences in the UK and throughout the world. Tensions and Barriers in Improving Maternity Care is a vital and challenging resource for all midwives, managers and policy makers and shapers with an interest in maternity and women-centred care. "A remarkably detailed analysis of the politics of a birth centre trapped in a medicalised system that threatened and rapidly destroyed it. It is a vivid example of how autonomous midwifery is undermined by an organisational structure in which management focuses exclusively on one model of care." - From the Foreword by Sheila Kitzinger 'I would recommend this powerful book to all supervisors of midwives as it provides profound insights into the impact of loss and grief upon the midwives who are often left feeling isolated and vulnerable when dealing with difficult circumstances.' - Nessa McHugh, lecturer in midwifery at Edinburgh Napier University, and leader of the Preparation and Practice of Supervisors of Midwives programme.