Maternity failings: the birth of the new norm?

So much so, good care has become the exception rather than the rule.

Maternal deaths are at a 20-year high. One in three women have a traumatic birth. Thousands of babies are dying before, during or after labour. Thousands more are left with a life-changing brain injury due to errors in their birth. Almost half of NHS maternity units are rated inadequate and two-thirds are failing at safety. Women are belittled, berated, and denied the choice to make their own decisions about their care.

And people wonder why the national birth rate is so low.

Things go wrong too often that birth injury claims against the NHS are continuing to rise. The health service spent over £1.1 billion last year compensating families for negligence during maternity care. 

When things do go wrong, the fear of litigation often prevents staff from being open about their mistakes and learning from them. Blame culture is rife in maternity services, leaving families waiting years for answers and compensation.

Of course, childbirth is not without risk and sometimes things happen that cannot be controlled but neither should it be something to fear. However, as poor maternity care becomes the norm, and its consequences ever damaging, it is only normal for pregnant women to have concerns for the safety of themselves and their unborn children.

Every woman wants – and has a right to – the safest possible birth for herself and her baby. However, the fundamental principles of good health care - the importance of women being able to make choices about their care, and the safety of the mother and baby – are often lacking.

The health secretary, Wes Streeting, has called it a cause for national shame and the NHS’ chief midwifery officer, Kate Brintworth has admitted that care is not at the level it should be.

Despite an increasing number of high profile reviews into maternity services, lessons are not being learned. We desperately need a culture change to reinstate dignity, compassion and care back into maternity services before more tragedies occur.

Here we look at some of those failings, with stories from some of our clients we have supported to make a birth injury medical negligence claim.

CQC annual report: The birth of another scandal

A damning review by the Care Quality Commission (CQC) has found that preventable harm within maternity care is at risk of becoming the norm.

The CQC has reviewed 131 maternity units over a 16-month period. Almost half (48 percent) were graded inadequate or needing improvement, and 65 percent are failing at patient safety.

The healthcare regulator found common themes amongst the failing NHS trusts.

• Staffing – Low staffing levels means recent graduates are doing tasks better suited to senior midwives or doctors
• Poor care – Mothers have no privacy or dignity on cramped and overheated labour wards, limited access to toilet and shower facilities, and are left to lie on bloody bed sheets
• Broken equipment – Call bells not working and poor pain management systems
• Discrimination – ethnic women treated more unfairly than white mothers
• Surgery delays – Back logs and unavailable space in theatres means emergency and planned caesarean sections are being delayed
• Safety – Inconsistent monitoring and recording of safety incidents, with major emergencies recorded as low or no harm
• Leadership – blame culture at senior level and low morale amongst all staff

Major failings at various NHS trusts have hit the headlines over the last ten years.

There have been maternity investigations at:

• Morecambe Bay 2015 – Three mothers and 16 babies died during or shortly after birth due to inadequacies in care within the maternity department at Furness General Hospital. The Morecambe Bay investigation found that, with different clinical care, the deaths of one mother and 11 babies could have been prevented.
• Shrewsbury and Telford 2022 – Over 200 babies and nine mothers died unnecessarily due to failings at the Royal Shrewsbury and Princess Royal Hospitals. The Ockenden report looked at cases of 1,486 families between 1973 and 2020.
• East Kent 2022 – Over a hundred babies and their mothers suffered significant harm or died as a result of suboptimal care at maternity units of the Queen Elizabeth Queen Mother Hospital and William Harvey Hospital between 2009 and 2020. Of the 202 cases reviewed by the East Kent inquiry, which included 65 baby deaths and 17 cases of brain damage, more than half would have had a different outcome if trust staff had followed nationally accepted standards of care.
• Derby and Burton 2024 – A review into 157 baby deaths between 2020 and 2023 found care issues which may have affected losses of life. The independent review was triggered last year by the trust having perinatal mortality rates significantly above the national rate
• Nottingham (ongoing) – The largest of all maternity investigations, the Ockenden Notttingham review is looking at the cases of almost 2,000 families cared for at two hospitals between 2012 and 2022. The report is set to be published in September 2025.

But as the CQC review states, failings are fare more widespread than just a few bad apples.

Listen to Mums: Government backed birth trauma inquiry

In May 2024, the findings from the government’s birth trauma inquiry – the first of its kind – were published.

The inquiry heard from 1,300 people and 100 maternity professionals who shared harrowing stories about their experience of birth trauma. They told of stillbirths, premature births, having a baby with cerebral palsy because they were deprived of oxygen during labour, or ending up with life-changing injuries of their own due to severe perineal tearing.

These incidents were caused by mistakes and failures before and during birth, with a concerning amount of cover-ups by hospitals in the aftermath of such events.

Women recalled being labelled as an anxious mother if they raised concerns to midwives. There was an overriding theme that doctors and midwives failed to listen to them and treated them as an inconvenience.

Other key themes included:

• Lack of informed consent
• Poor communication
• Denied pain relief
• Lack of kindness
• Poor quality postnatal care

The report found that one in three pregnant women have a traumatic birth, and about 30,000 women a year in the UK – around five percent of those who give birth – develop PTSD.

Mothers were unable to bond with their baby because of the traumatic realisation of what happened during birth. Some faced providing round-the-clock care for children left severely disabled as a result of birth injuries. Others were too incapacitated by injuries they sustained while giving birth, such as chronic pain or bowel incontinence, that they couldn’t return to work. Many women described their injuries as having destroyed their sense of self-worth, impacting their relationships with their partners and wider families.

The report called for an overhaul of maternity care as well as the need to introduce a base standard in maternity services across the country through the introduction of a maternity improvement strategy.

Maternal deaths reach 20-year high: MBRRACE report

In October 2024, MBRRACE-UK, which monitors maternal deaths, stillbirths and infant deaths and their causes, released their annual Saving Lives, Improving Mothers' Care report.

The report highlighted how maternal deaths have reached a 20-year high. Between 2020 and 2022, 275 women died in pregnancy or the first six weeks after birth. A quarter of these women died in the first trimester of pregnancy.

The leading cause of maternal death was thrombosis – or blood clots – which accounted for 16 percent of all cases. Other reasons included cardiac disease, ectopic pregnancies, sepsis, stroke, postnatal bleeding, cancer and pre-eclampsia.

The report also found that pregnant women over the age of 35 were three times more likely to die than those aged 20 to 24. Black women were also three times more likely to die, bringing to light the inequalities in maternity care.

Assessors identified many common themes including:

• The importance of recognising concerning symptoms that indicate underlying conditions.
• Symptoms such as persistent nausea and vomiting inappropriately attributed to pregnancy without further investigation of the cause.
• Confusion in when and how to use venous thromboembolism (VTE) risk assessment tools and interpret a woman’s risk score.
• Delays in pre-hospital care, especially in women who died from ectopic pregnancy.
• Pregnancy not considered as part of the differential diagnosis until women arrived in the emergency department and abdominal bleeding was discovered by point-of-care ultrasound.
• Lack of or inappropriate imaging and treatment due to pregnancy.

Avoiding Brain Injury in Childbirth (ABC) programme rolled out by NHS

In October 2024, the NHS launched a pilot scheme across nine maternity units to reduce brain injuries in childbirth. The £7.8m ABC scheme is part of the government’s ambition to urgently improve maternity outcomes for women and babies.

The funding will be used for training to help maternity staff better identify and act quickly when babies are in distress during labour or have become lodged in the pelvis during caesarean section.

It aims to put families back at the centre of maternity care by improving clinical practice, communication and care standards.

Around 2,500 babies received at least one episode of care for brain injury during or after birth in 2021. That equates to 4.2 in every 1,000 births.

Brain injuries can cause life-changing conditions like cerebral palsy. Often, these injuries are the result of errors during the birth of the child. This might include limited or interrupted oxygen supply if the baby becomes stuck in the birth canal, a bleed on the baby’s brain or trauma to the head during assisted delivery, a failure to identify placental problems like praevia or abruption, or delayed diagnosis of infections like meningitis or Group B Strep.

Huge payouts are made to families of babies with brain injuries, with individual cases reaching up to £30 million for children with severe disabilities who require round-the-clock care.

If pilot of the new ABC scheme is successful, it is hoped that it will become national from next year.

Examples of birth injury compensation claims

Here are some of the birth injury cases that our team at Medical Solicitors, a medical negligence law firm, have successfully settled in recent years. These are real people who have been affected by failures in maternity services.

£350,000 for estate of mum of four who died from cardiac arrest after c-section

This case was settled by our director, Matthew Brown, for the estate of a 33-year-old woman who died shortly after childbirth due to multiple missed opportunities to diagnose pulmonary hypertension.

Despite two abnormal ECGs and complaints of chest pain, shortness of breath and palpitations over a four-year period, there was no referral to cardiology. The woman was only diagnosed with pulmonary hypertension, a rare form of high blood pressure affecting the lungs and heart, just nine days before her death.

She gave birth to her fourth child and first daughter via caesarean section but went into cardiac arrest shortly after. Resuscitation attempts were unsuccessful and she died before she got to hold her daughter. She left behind a partner, three sons and her baby girl.

£280,000 for substantial injuries during forceps delivery

This case was settled by our director, Christine Brown, on behalf of a 26-year-old woman who needed an emergency hysterectomy following a failed attempt to deliver her third child.

The baby was large and the woman had previous history of shoulder dystocia, but maternity staff repeatedly refused her pleas for a caesarean section. She told them numerous times that the baby felt stuck and couldn’t be delivered naturally. But they insisted she keep pushing until an attempt was made using forceps in theatre. However, the baby’s head had been wrongly identified as engaged by a doctor when it was actually traverse.

As they applied the forceps blades, the woman suffered substantial trauma to the genital tract (vagina, uterus, fallopian tubes and ovaries). She lost 6.5 litres of blood, needing a transfusion, emergency c-section and, ultimately, a hysterectomy due to the nature of the injury. She is now unable to conceive any further children and the compensation included a claim for surrogacy costs in the USA.

£120,000 for stroke in pregnancy due to wrong dose of blood thinners

This case was settled by senior solicitor, Louise Haslam, on behalf of a young woman with a blood disorder who had a stroke in her second trimester after being given the wrong dose of an anticoagulant.

On finding out she was pregnant with her first child, she had to stop taking Warfarin to reduce the risk to her unborn child. She was instead prescribed a low molecular weight heparin. However, she was incorrectly given a half dosage of the anticoagulant. At 25 weeks pregnant, she had a stroke caused by the incorrect dose.

Thankfully, she made a good recovery, due to her own determination, but her injuries did impact on the early months with her newborn child as a first-time mum.

£25,000 after premature baby died from sepsis following thrush infection

This case was settled by Sarah Johnson for a mother whose baby son who died at less than two weeks old from thrush that had turned into sepsis.

Maternity staff failed to adequately treat thrush in the mother during pregnancy, resulting in baby being born early at 29 weeks. A vaginal swab showed a thrush infection but results were not brought to the attention of the neonatal team until too late.

The baby boy required assisted breathing for three days before being taken off the ventilator and started on antibiotics. The mother was told her son would be fit for discharge at two-weeks old, but after nine days he started with hiccups which were later diagnosed as seizures that increased in frequency up to every 30 seconds.

It was only when he was 12 days old that microbiology advised his blood culture was positive for yeast and he was given anti-fungal treatment. However, the following day he was pronounced brain dead and life support was withdrawn.

£3,000 for incorrect diagnosis of 3rd degree perineal tear

This case was settled by Chanel Watson on behalf of a woman in her early 30s whose third degree perineal tear was wrongly diagnosed as second degree and so was inadequately repaired.

After the birth of her first child, it was noted that she had suffered a 2nd degree tear which was repaired by Locum Obstetric Registrar. Later that day, she lost around 700ml of blood and was examined by a consultant to check for clots. However, they couldn’t reach her cervix so she was taken to theatre where the original sutures were removed.

It was found that she actually had a 3a third-degree tear, and she was therefore sutured incorrectly. The anterior lip of the cervix has been stitched to the posterior vaginal wall and two labial tears had also been stitched together, resulting in a narrow opening. Placental tissue was found in her womb, along with more than 400ml of clot.

Medical Solicitors: Here for you

If you feel you’ve received substandard medical treatment whilst pregnant or during birth, or your child was injured due to mistakes at birth, our medical lawyers are on hand to help.

At Medical Solicitors, our experienced team of lawyers specialise in medical negligence claims. They have the knowledge and skills needed to properly investigate a potential birth injury claim. Our team also calls upon the advice of nurses, midwives and obstetricians who can provide medical opinion and evidence to support your case.

If you're not sure whether your case constitutes maternity negligence or could be a successful claim, please see our guide to birth injury medical negligence cases or speak to our team.