Women in labour have been mocked, ignored, fobbed off with paracetamol and left with permanent damage by midwives and doctors, and hospitals have covered up their staff’s failures, a damning report by MPs has found.
Mothers have been left with post-traumatic stress disorder (PTSD), unable to bond with their baby and too incapacitated to go back to work because of horrendous experiences while having a child, the UK’s first inquiry into birth trauma found.
Poor childbirth care is so common, and its consequences so damaging, that ministers and NHS bosses need to push through significant changes to how maternity staff look after the 600,000 women a year who give birth in England, the all-party parliamentary group (APPG) for birth trauma said.
The report outlines how 1,311 women who had a traumatic birth told the inquiry “harrowing” stories about stillbirth, premature birth or having a baby with cerebral palsy because they were deprived of oxygen during labour, or ending up with life-changing injuries caused by severe tearing.
“In many of these cases the trauma was caused by mistakes and failures made before and during labour. Frequently these errors were covered up by hospitals who frustrated parents’ efforts to find answers,” the APPG’s 80-page report says.
“There were also many stories of care that lacked compassion, including women not being listened to when they felt something was wrong, being mocked or shouted at and being denied basic needs such as pain relief.
“Women frequently felt they were subjected to interventions they had not consented to, and many felt they had not been given enough information to make decisions during birth. The poor quality of postnatal care was an almost universal theme. Women shared stories of being left in bloodstained sheets or of ringing the bell for help but no one coming.”
One in three women who have a child have a traumatic birth, and about 30,000 women a year in the UK – 4% to 5% of those who give birth – develop PTSD, the report says.
Birth trauma leads to “difficulty in bonding with the baby, stress on the relationship with their partner and wider family and, often, an inability to return to work”.
Some women told the cross-party group how injuries they sustained while giving birth had left them with “a lifetime of pain and bowel incontinence. Many of these women could no longer work and described their injuries as having destroyed their sense of self-worth.
“Other women wrote movingly of having to provide round-the-clock care for children left severely disabled as a result of birth injuries,” the MPs said.
Their recommendations include advice to the government to appoint a maternity commissioner, who would report to the prime minister; create specialist postnatal services that give women a “safe space to speak about their experiences in childbirth”; compel hospitals to offer antenatal classes at which childbirth’s risks are discussed; and give mothers-to-be pain relief when they ask for it.
Victoria Atkins, the health secretary, pledged to set out a plan for how to make the system “faster, simpler and fairer” after the “harrowing” stories were revealed.
The inquiry was led by the Conservative MP Theo Clarke and the Labour MP Rosie Duffield.
Amanda Pritchard, NHS England’s chief executive, said: “The experiences outlined by women in this report are simply not good enough and not what the NHS wants or expects for patients.”
She said the NHS was making progress in improving maternity care and support for women who had a traumatic birth. She cited the rollout of a network of pelvic health clinics, expansion of community-based maternal mental health support and a move to ensure GPs offer mothers a checkup of their own physical and mental health six to eight weeks after giving birth, which is separate to the check on the baby’s health at the same stage.
Maria Caulfield, the women’s health minister, on Monday apologised to mothers affected by birth trauma for the failings in care. She said ministers had got their approach to maternity services wrong for a long time.
“Absolutely,” Caulfield said when asked if there was an apology to be made. “I recognise as women’s health minister that maternity services have not been where we want them to be,” she told Sky News.
The NHS in England is spending £1.1bn a year settling legal claims involving medical negligence in maternity care, “an eye-watering third of the NHS’s total budget for these services”, the Commons public accounts committee reported last week. Ministers had no plan to “reduce the amount of tragedy” that medical negligence caused and the £21bn in claims the NHS was facing, the MPs added.
The Care Quality Commission, the NHS care watchdog, said in its annual report last October that the care provided in two-thirds of NHS maternity units in England was not good enough.
Major inquiries have been undertaken in the last decade into failings in maternity care at three NHS trusts – Morecambe Bay, Shrewsbury and Telford, and East Kent. A fourth, into problems at Nottingham university hospitals NHS trust, is under way.
