Poor maternity tolerated as normal, inquiry says

An inquiry into traumatic childbirths has called for an overhaul of the UK's maternity and postnatal care after finding poor care is "all-too-frequently tolerated as normal".

The Birth Trauma Inquiry heard harrowing evidence from more than 1,300 women - some said they were left in blood-soaked sheets while others said their children had suffered life-changing injuries due to medical negligence.

Women complained they were not listened to when they felt something was wrong, were mocked or shouted at and denied basic needs such as pain relief.

A new maternity commissioner who would report directly to the prime minister is a key recommendation in the inquiry's report, along with ensuring safe levels of staffing.

Health Secretary Victoria Atkins said she was determined to improve the quality and consistency of care for women.

NHS England chief executive Amanda Pritchard said the experiences outlined in the report "are simply not good enough".

It is estimated that 30,000 women a year, in the UK alone, have suffered negative experiences during the delivery of their babies. One-in-20 develop post-traumatic stress disorder (PTSD).

The findings of the first UK inquiry into birth trauma will be presented to ministers on Monday, before Ms Atkins is expected to set out the government's response.

The inquiry's authors call for a maternity system "where poor care is the exception rather than the rule".

Parents gave the inquiry accounts of stillbirth, premature babies and babies with cerebral palsy caused by oxygen deprivation - in many cases trauma caused by mistakes and failures, often covered up, before and during labour.

Other devastating accounts came from women who experienced birth injuries, causing a chronic pain and bowel incontinence, stopping many of them working and "destroying their sense of self-worth".

Women from marginalised groups, particularly ethnic minority groups, appeared to experience particularly poor care, with some reporting direct and indirect racism, the inquiry highlighted.

Liberal Democrat MP Helen Morgan, who was among the MPs responsible for the inquiry, said it was "nothing short of a national tragedy" that so many women had experienced traumatic births.

Tory MP Theo Clarke, who chaired the inquiry, told the BBC there was "a postcode lottery" for maternity care in this country.

Speaking to BBC Radio 4 Today programme, she said: "I don’t think is acceptable – that depending on where you live, you will literally be offered a different level of care in terms of how you’re given support during childbirth and afterwards.”

Ms Clarke said she hoped the government, who she said had worked "very constructively" with the inquiry, would implement all the recommendations made by the report.

Describing her own personal experience of giving birth, she said: “I remember pressing the emergency button after I’d come out of surgery and a lady came in and said she couldn’t help me, said it wasn’t her baby, wasn’t her problem and walked out and left me there.

“So we need to make sure there are safe levels of staffing.”

In an emotional speech in the House of Commons in October, Ms Clarke broke down as she described being rushed into emergency surgery after the birth of her daughter, terrified that she was going to die.

She bled heavily after suffering a third-degree tear and had to undergo a two-hour surgery without general anaesthetic, due to an earlier epidural.

In the report, one mother, Helen, was described as still suffering from mental and physical pain - years after the birth of her son, Julian. He was born with a hypoxic brain injury as a result of proven medical negligence during his birth.

"My life will never be as it should be," she told the inquiry. "I never returned to work, I live a very secluded life, as friends and family shun you when you have a disabled child that they might not understand or are scared of."

The report called for a "base standard in maternity services" across the UK and an end to the postcode lottery of perinatal care. It said mothers should be given "universal access to specialist maternal mental health services across the UK".

It also urged the government to outline how it would "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".

In the report, Ms Clarke and her co-chair Labour MP Rosie Duffield said the inquiry wanted to start a public discussion "on the realities of giving birth and how we can practically improve maternity services" - as well as share the stories and experiences of both mothers and fathers.

Another key suggestion was to "provide support for fathers and ensure [a] nominated birth partner is continuously informed and updated during labour and post-delivery".

The report from the All-Party Parliamentary Group on Birth Trauma put forward 12 recommendations in total, including:

• Recruit, train and retain more midwives, obstetricians and anaesthetists to ensure safe levels of staffing
• Respect mothers' choices around giving birth and access to pain relief
• Commitment to tackling inequalities in maternity care for ethnic minorities, particularly black and Asian women
• Universal access to specialist maternal mental health services to end the postcode lottery across the UK

Since covering the inquiry's findings, BBC News has received dozens of messages from women telling their own traumatic child birth stories.

Gill Castle, who suffered extensive injuries when her son Sam was born and needed surgery to have a stoma, told BBC Breakfast "it was no surprise" the inquiry uncovered harrowing stories.

"Part of the reason has been understaffing. Certainly for me when I was on the ward we didn't have enough midwives and it wasn't enabling them to their job," she said.

Women's Health Minister Maria Caulfield apologised when the BBC Radio 4 Today programme played calls from parents detailing their experiences, including one man who's wife survived losing 82% of her blood giving birth.

"Just to apologise for his and his wife's experience and to those of your callers as well," she said. "We do recognise that and that's why over the last few years we've been putting in some of the measures that this report calls for."

When asked if the government would appoint a maternity commissioner, she said it would need to look at the report and what difference a commissioner would make.

She added that the number of midwives was being increased and already addressing at least five of the 11 recommendations in the birth trauma inquiry report.

Health Secretary Ms Atkins said in a statement in response to the report that she was grateful to the women who came forward to share their experiences.

“I am determined to improve the quality and consistency of care for women throughout pregnancy, birth and the critical months that follow, and I fully support work to develop a comprehensive national strategy to improve our maternity services," she said.

Ms Atkins also highlighted progress in GP appointments for all new mothers after giving birth to check in with how women are doing, and by the end-of-the year completing the roll-out of new physical and mental services for new mothers and pregnant women available in all areas of England.

NHS chief executive Ms Pritchard said: "We know there is more that can be done to prevent and improve support for birth trauma, which is why we are committed to working with the Department for Health and Social Care on a cross-government strategy to build on the NHS three-year delivery plan for maternity and neonatal services, so that we can continue to make care safer and more personalised for women and babies.”