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The financial issues for birth centres are: Those that conduct a small number of births--certainly those conducting less than 100 births a year--are unlikely to generate income that covers their costs; In future, all community activity will come under PbR and it will then be much easier to identify how much antenatal and postnatal activity occurs from birth centres and what income should therefore be derived from that activity; Even if a birth centre is financially viable in its own terms, will it make economic sense as part of the entire maternity service? For a freestanding unit, it is clear that in terms of economies of scale, two sites will almost always be more expensive than one; For birth centres to survive, they must be able to demonstrate a sound business case that balances financial affordability with the wider policy agenda. The business case for birth centres has to be made in terms that make sense to the rest of the NHS.