NHS Maternity Care Failures: Why Urgent Reform Is Needed

Last week saw yet another hospital Trust in the news for providing inadequate maternity care, with poor care resulting in a significant number of avoidable stillbirths and baby deaths.

A Growing Pattern in Maternity Care Failures

It is now a regular occurrence to see such reports in the media, and the problem appears widespread. Why is this happening and why does it seem to be an increasing problem? I don’t profess to have all the answers, that would be for another inquiry*, but I do see some recurring themes in cases where I have been instructed by bereaved parents.

Underfunding and Capacity Issues in NHS Delivery Suites

Under funding in the NHS has been a problem for some considerable time and I think this is one of the reasons there is also a real issue in delivery suites across the country. So often I have read a mother’s notes where you see it written that she cannot be admitted because there is no capacity, or it is recorded the mother could not be given one to one care because the midwife was looking after several other women at the same time. When the midwives are so busy, they can easily miss subtle signs of something not being right with the baby. Likewise, without continuity of care with the same midwife things can be missed or action taken too late. This is not a criticism of midwives who in my experience are wonderful despite the enormous pressures on them. It is a resources problem. There needs to be more funding and more midwives and staff.

Concerns Ignored During Early Labour

I have also seen cases where the mother has telephoned the maternity unit several times with concerns that all is not right whilst in early labour but been wrongly advised to stay at home. This may be due to the delivery suite being too stretched to take another labouring mother at that time or a training issue.

Misinterpretation of Foetal Monitoring

Another recurring theme is the monitoring of the foetal heart during labour and the results being misinterpreted as a reassuring heart rate when in fact it is showing a baby who is struggling. Is this a training issue? I don’t know the answer, but it needs addressing.

Seeking Accountability and the Importance of Saying Sorry

When parents approach me for help, it isn’t to establish how much compensation they may get if they claim against the hospital, it is to try and find answers to what went wrong, to make sure lessons are learned so it doesn’t happen to another family, for there to be some accountability and, importantly, for someone to say sorry. Saying sorry is not an admission liability but an apology for something that went wrong. Some Trusts are very good in being candid when things go wrong and offering an apology and, in my practice, I do see Defendant Solicitors’ and Trust claim handlers apologising where avoidable errors have been made. There does however need to be more consistency within the medical profession in applying the Duty of Candour.

Looking Ahead to the National Maternity Care Investigation

I very much hope the powers that be are taking notice of all these cases and take the steps needed to ensure other parents do not have to endure such loss.

Since preparing this piece the Health Secretary, Wes Streeting, has announced a national investigation into maternity care in England. The investigation is due to report back by December 2025.

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