The Royal College of Midwives (RCM) has expressed concern over reports that two maternity units could close in Norfolk, because apparently pointing out that closing maternity units might be bad for people giving birth is now a controversial stance.

Norfolk has maternity units at hospitals in Norwich, Gorleston and King's Lynn, with the latter two also serving Cambridgeshire and Suffolk. The trade union posted on Facebook that local maternity services should be invested in rather than cut - a radical proposition, we know.

The Norfolk and Waveney University Hospitals Group (NWUHG) has set out its "Case for Change" on how services could be delivered in future, but stressed that no decisions had been made and no consultation had begun. NHS leaders said any move to concentrate services at one or two sites would be based on providing safer care for women and babies. The RCM, however, warned that closing units serving rural and isolated communities could mean women travelling "unacceptable distances" while in labour - a scenario that sounds less like a healthcare plan and more like a plot device in a road movie.

If maternity services were removed from hospitals, the union said neonatal units and children's inpatient wards would also close because the services were inter-dependent. Options include keeping services as they are, or closing consultant-led maternity units at the James Paget Hospital in Gorleston, the Queen Elizabeth Hospital in King's Lynn, or both. As well as women in Norfolk, the plans could affect women in Lowestoft and north Suffolk who give birth in Gorleston and those in Wisbech and north-east Cambridgeshire who travel to King's Lynn.

The RCM argued the proposals risked worsening existing inequalities in maternity outcomes and said the answer was investment and more staffing, rather than allowing services to "shrink." It also said closures could result in midwives being redeployed further from home. The Facebook post said: "Women and babies deserve safe, local care, and closing units is not the answer." The Department of Health and Social Care has been contacted for comment, presumably while practicing its own neutral face.

NWUHG said 60 clinicians had helped develop the review. The Case for Change argues that falling birth rates, workforce shortages and increasing numbers of women requiring more complex care are making it harder to sustain specialist services at every site - a set of challenges that, notably, do not include "too many midwives sitting around with nothing to do."

Lesley Dwyer, NWUHG chief executive and a former midwife, previously told the BBC the review was one of the most significant pieces of work undertaken by the organisation and was aimed at making services sustainable in the long term. "The scenarios examined so far are a starting point for further assessment, not formal proposals," she said. "No preferred approach has been identified and no decision has been made to close or relocate these services. Patient safety must remain at the centre of this work. We also need to understand what different approaches could mean for choice, travel, access and the experiences of women, babies, children and families."

The work comes after NHS bosses said that smaller maternity units across the country may have to close. The Case for Change will now be submitted to NHS England before further research and any public consultation takes place - because nothing says "patient safety at the centre" like a multi-stage review process with no decisions made yet.