NHS Birth Trauma Inquiry

In January 2024, an inquiry was established within Parliament to look at maternity care across the UK, what the main failings were and what improvements were needed. The inquiry has now published its report, and the government has been asked to confirm what steps will be put in place to follow up on its recommendations.

What did the inquiry say?

Sadly, the overarching theme of the report was poor quality maternity care across much of the UK, and a ‘postcode lottery’ for expectant mothers, as to the standard of care they could expect to receive in their area.

Evidence was heard from more than 1,300 women, along with medical professionals. Key points which arose from the report included:

• Failure of medical staff to listen to women and their concerns: often women were simply told they were being over-anxious;
• Lack of informed consent: women reported not being given adequate information about examinations and procedures, no information about risks and benefits, and little or no information about the risks relating to tearing during childbirth;
• Poor communication;
• Complaints and medical negligence

As a Clinical Negligence solicitor, these are themes which I see time and time again in cases, which have led to unnecessary and avoidable injury, trauma and sometimes death for women and babies.

The report concluded with recommendations for a ‘good maternity service’ including:

• Antenatal education: this is not provided by the NHS routinely across the country and a lot of women have to pay privately for this;
• Listening to women;
• Consent – taking this seriously and following already set GMC guidance on this issue;
• Transparency and accountability: there had been reports during the inquiry of errors being covered up and professionals not being open about mistakes;
• Mental health support: routine screening should be offered to ensure women and partners can be referred for support if suffering mental trauma following birth

Signs of birth trauma

With regards to injury to babies, clients often describe a sudden change in atmosphere in the room, more urgency, more people coming in to help with delivery or resuscitation of the baby when they are born. Clients describe babies being taken away to be treated, placed in incubators, mothers not being able to hold or try feeding baby straight away. Clients might be told of the need to run additional tests on the baby, or do CT or MRI scans to check for injury.

We often see instances of failure during the antenatal period to adequately monitor the mother, for example with growth scans or for gestational diabetes, or failure to advise in relation to reduced fetal movements. Issues can also arise related to the monitoring of mother and/or baby adequately during labour, and to expedite delivery once concern is noted. These delays can cause a significant difference in outcomes between a healthy baby, a baby with minor cognitive difficulty, and a baby with significant disabilities.

Later down the line, trauma to babies can manifest itself as failing to meet particular milestones like eye movement, sitting up, walking or talking. There might be seizures. There might be other unusual behaviour, or difficulties with gross or fine motor skills.

With regards injuries to mothers, this often relates to perineal tearing. These can range in degree, and with adequate treatment from the beginning often cause no further problems. However, failure to identify the extent of a tear, or repair by someone who is not suitably qualified, can result in significant incontinence or breakdown of the repair and infection. This can cause permanent injury to the woman, significant mental health problems, breakdown in relationships and a decision not to have any more children.

Other traumatic injuries to women can also include haemorrhage, uterine rupture (if a natural delivery is attempted following a c-section) or failings leading to stillbirth.

What to do next?

If you have recently had a baby, and things seem to have been more traumatic than you envisioned, or you or your baby are now struggling with an injury, it is important to speak to the hospital and ask for a debrief. You should be able to meet with one or more of the professionals involved in your care, to discuss what happened and why.

You can also make a written complaint about how yours or your baby’s care was managed, and you should receive a response reviewing the records and explaining the outcome to you.

Sometimes, the hospital will start its own investigation – a Serious Incident Report – if it is considered a ‘serious incident’ has occurred, and this will mean that what happened during your antenatal care, labour and/or post-natal care will be reviewed by a team of people within the trust who are independent of those involved, providing a conclusion and possible recommendations for change in future.

There is also a body called Health Services Safety Investigations Body (HSSIB-previously HSIB) who may investigate, who are independent, but their involvement does not prevent you locating a solicitor whilst they investigate.

If you decide to speak with a solicitor, Price Slater Gawne have extensive experience in handling cases relating to injury to both mothers and babies following childbirth. It is useful to provide any and all copies of documents you hold relating to any debrief, complaint or investigation, as this can help to indicate where potential failings were, and whether outcomes could have been avoided.