Damning report into the standard of maternity care and services from the #BirthTraumaInquiry prompts apology from Government minister

14 May 2024

The All-Party Parliamentary Group on Birth Trauma has issued a damning report about the standard of maternity care and services entitled Listen to Mums: Ending the Postcode Lottery on Perinatal Care prompting an apology from the Women’s Health Minister.

The report acknowledges that the term ‘birth trauma’ covers a number of issues. First, it describes a woman’s experience of interactions and/or events directly related to childbirth that caused overwhelming distressing emotions and reactions, leading to short and/or long-term negative impacts on a woman’s health and wellbeing. It may also be used to describe injuries that the mother may have sustained during birth, such as third or fourth degree tears, uncontrolled pain or episiotomies. It notes that 4-5% of women develop post-traumatic stress disorder (‘PTSD’) every year after giving birth. The inquiry also considered evidence from cases of stillbirth and neonatal death.

Key these arising from the inquiry included failure to listen to patients, lack of informed consent, poor communication, lack of pain relief, lack of kindness, breastfeeding problems, postnatal care, the impact of Covid, and poor complaints and clinical negligence claim handling. Birth trauma is associated with individual failures of care and systemic issues.

After collating evidence from patients, relatives and healthcare providers, the All-Party Parliamentary Group put forward twelve recommendations:

  1. Recruit, train and retain more midwives, obstetricians and anaesthetists to ensure safe levels of staffing in maternity services and provide mandatory training on trauma-informed care.
  2. Provide universal access to specialist maternal mental health services across the UK to end the postcode lottery.
  3. Offer a separate 6-week check post-delivery with a GP for all mothers which includes separate questions for the mother’s physical and mental health to the baby.
  4. Roll out and implement, underpinned by sufficient training, the OASI (obstetric and anal sphincter injury) care bundle to all hospital trusts to reduce risk of injuries in childbirth.
  5. Oversee the national rollout of standardised post birth services, such as Birth Reflections, to give all mothers a safe space to speak about their experiences in childbirth.
  6. Ensure better education for women on birth choices. All NHS Trusts should offer antenatal classes. Risks should be discussed during both antenatal classes and at the 34-week antenatal check with a midwife to ensure informed consent.
  7. Respect mothers' choices about giving birth and access to pain relief and keep mothers together with their baby as much as possible.
  8. Provide support for fathers and ensure nominated birth partner is continuously informed and updated during labour and post-delivery.
  9. Provide better continuity of care and digitise mother’s health records to improve communication between primary and secondary health care pathways. This should include the integration of different IT systems to ensure notes are always shared.
  10. Extend the time limit for medical negligence litigation relating to childbirth from three years to five years.
  11. Commit to tackling inequalities in maternity care among ethnic minorities, particularly Black and Asian women. To address this NHS England should provide funding to each NHS Trust to maintain a pool of appropriately trained interpreters with expertise in maternity and to train NHS staff to work with interpreters.
  12. NIHR to commission research on the economic impact of birth trauma and injuries, including factors such as women delaying returning to work.

Kenneth Lees, Head of Clinical Negligence at Curtis Law Solicitors said of the report “We receive a very high number of enquiries from women concerned about the standard of care that they have received during their pregnancy and labour, with issues ranging from epidural and pain control issues, tears and substandard episiotomy repairs, through to life changing injuries for the mother and baby and fatalities. The conclusions of the All-Party Parliamentary Group are representative of the enquiries that we receive and the claims that we investigate. We hope that Government adopts the recommendations and that care and service standard improve in the near future”

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