Posted: 14/05/2024
In response to concerns about the standard of maternity care in the UK and the impact this is having on the safety of mothers and their babies, the all-party parliamentary group (APPG) on birth trauma has this week published its report.
In October last year, the Care Quality Commission ranked two-thirds of maternity units as ‘inadequate’ or ‘requires improvement’, the Maternity Safety Alliance (MSA) wrote to the health secretary requesting a statutory public inquiry into maternity safety, and Theo Clarke MP led the first ever debate on birth trauma in Parliament, talking openly and passionately about her own experience of childbirth.
In January 2024, the birth trauma APPG set up the inquiry aimed at understanding why so many women experience traumatic birth and how the current state of maternity care can be improved. At that time, research showed ‘4-5% of women developed post-traumatic stress disorder (PTSD) after giving birth and as many as one in three found some aspects of their birth experience traumatic.’
The report ‘Listen to Mums: Ending the Postcode Lottery on Perinatal Care’ was published on 13 May 2024. The full document can be found here.
The report identifies key problems with maternity care, including mistakes and failures in care, both before and during labour, which led to ‘stillbirth, premature birth, babies born with cerebral palsy caused by oxygen deprivation and life changing injuries to women’. It is noted that ‘frequently, these errors were covered up by hospitals who frustrated parents’ efforts to find answers’. There is also an acknowledgment that the statutory duty of candour, the duty to be open and transparent about care and to acknowledge when things have gone wrong, is not being applied effectively.
Women reported a lack of compassion from midwives and doctors, and ‘frequently felt they were subjected to interventions they had not consented to and many felt they had not been given enough information to make decisions during birth’. The inquiry noted ‘harrowing’ stories of childbirth and confirmed that ‘some of the most devastating accounts came from women who had experienced birth injuries, causing a lifetime of pain and bowel incontinence’. There was an ‘almost-universal theme’ of poor quality post-natal care and ‘women from marginalised groups, particularly those from minoritised ethnic groups, appeared to experience particularly poor care, with some reporting direct and indirect racism’.
The inquiry also considered the social and financial impact of birth trauma including difficulties bonding with the baby and pressure on family relationships, deciding not to have any more children, and being unable to return to work.
Maternity professionals were also consulted and many reported that they were overworked and understaffed, and there was a harmful culture of bullying. They experienced high levels of stress and burnout, mental health related absences and many had considered leaving the profession.
The birth trauma inquiry report makes recommendations for a more ‘woman-centred’ approach, where mothers are treated with compassion and respect, and ‘poor care is the exception rather than the rule’. To achieve this, the inquiry suggests that the UK government should publish one over-arching ‘National Maternity Improvement Strategy’, to be led by the new ‘Maternity Commissioner’, focusing on the following:
Sarah Hibberd, an associate in Penningtons Manches Cooper’s clinical negligence team specialising in maternity care and birth injuries, comments: “Whilst birth can sometimes be difficult even with excellent care, it is evident that underperforming maternity services are contributing to the difficulties women face, and a substantial proportion of women are having traumatic birth experiences.
“As a clinical negligence solicitor, I work with families who have experienced substandard care during pregnancy, labour or delivery, causing injuries to mother and baby, and sometimes even leading to death. It is unbelievably frustrating to see repeated patterns of poor care and mistakes being covered up. To ensure safer care, it is imperative that maternity services are honest about their failures and learn from mistakes by implementing training and better procedures. For the sake of all mothers and babies, I hope the government heeds the recommendations in the report and uses the £35 million pledged in the Spring Budget to work towards improving maternity care.
‘The limitation date for issuing court proceedings in a clinical negligence claim is usually three years from the date of negligent treatment (for adult claimants). It is therefore interesting to see the suggestion that, for clinical negligence claims relating to childbirth, the time limit should be extended to five years. I fully support this proposal because, understandably, families are often traumatised by negligent treatment and are busy dealing with the practicalities of arranging medical care to address the injuries they have suffered, dealing with the struggles of daily life living with physical and/or psychological injuries, caring for a baby who has suffered a brain injury, or grieving a mother or baby who have not survived. At times like this, considering a clinical negligence claim and speaking to solicitors might not be at the forefront of their mind so, by allowing some extra time, it gives people breathing space to consider their options. If this proposal is accepted, it will be interesting to see whether it is also considered for other types of clinical negligence claim.”