Midwives and maternity services face considerable challenges but also unparalleled opportunities in providing and maintaining high quality midwifery services. The importance of high quality maternity services to the health and wellbeing of the population is increasingly recognised by women and their families, by policy makers and by clinical staff. Understanding and meeting rising expectations is a key component of quality. Maternity service providers and midwives will therefore want to consider how to adapt the way they work and organise themselves to deliver, flexibly, the highest quality of care