A dangerous time for both mother and child, in the past childbirth could cause as much anxiety as it did celebration. When the NHS was founded, there was close to a 1-in-25 chance a baby would be stillborn or die within the first week after birth. That figure has improved remarkably, and the risk of tragedy is now around 1-in-200. Whilst childbirth is safer than ever, there are still too many families that are having to experience the tragedy caused by unnecessary complications.
The causes of failures in maternity care
The NHS has seen a number of scandals centred around maternity units in recent years. Unfortunately, these often follow years of problems and many injuries and deaths. The steady stream of scandals suggests that lessons from each case are not always being learned by other NHS trusts. This is concerning as on occasion similar themes emerge from these investigations.
Mothers and families often report that their concerns have not been listened to or acted on. Naturally, mothers are particularly attentive to their child’s needs, but some mothers have unfortunately found their concerns dismissed or downplayed, only to later discover that opportunities to prevent harm to their child are missed.
Staffing problems are frequently a feature. These can include staff shortages, meaning that maternity units operate at dangerous levels with staff unable to adequately manage the workload. It can also include the use of inexperienced or unqualified staff — sometimes to help cover shortages — meaning that they do not identify potential issues or problems, take the wrong action, or simply lack the expertise they need to deal with complex pregnancies Finally, cultural problems and understanding are common. Many inquiries have uncovered widespread bullying, or managers that do not listen to staff and cover-up incidents. Trusts have also been found to prefer and encourage natural childbirth, pressuring both mothers and staff away from Caesareans. This is not just about a mother’s preference; it has also meant that hesitation and delay when faced with complications resulting in incidents that would have been avoided by prompt surgical intervention.
Poor maternity care: A costly problem
These problems come at a huge cost to the NHS. It’s estimated that poor maternity care comprises about 40% of the compensation paid for negligence claims by the NHS — about £900 million in the 2020/21 financial year — despite being only around 9% of the claims made.
But the cost is not just financial. Every claim can represent a child who never lived to achieve their potential, a mother who will never see her baby grow, or a family facing a lifetime of caring responsibilities. Launching a Parliamentary Select Committee investigation into maternity services last year the Committee chair, Jeremy Hunt MP, observed that if the UK matched Sweden’s neonatal death rate, then 1,000 fewer babies would die each year.
Major maternity scandals
There are few Trusts that will not have experienced an avoidable incident during childbirth, however, some of the major scandals in recent years have affected hundreds of families over periods of years.
2002-2005 — London North West University Healthcare NHS Trust
The high number of deaths at Northwick Park Hospital between 2002 and 2005 resulted in two investigations. They found the Trust’s maternity services were badly led, understaffed and under-equipped, with poor relationships between midwives and consultants.
Sadly, the Trust has again been in the news, with the hospital rated ‘Inadequate’ and maternity services assessed as a ‘risk to patient safety’ by the Care Quality Commission (CQC) after eight neonatal deaths in 2020.
2004-2013 — University Hospitals of Morecambe Bay NHS Foundation Trust
The tragic deaths of 11 babies and a mother at Furness Hospital resulted in an inquiry into the service. Shockingly, the inquiry found not just that the problems had been caused by a lack of competence and midwives pushing natural childbirth, but that there was a cover-up culture.
Like Northwick Park, the Trust has failed to maintain standards following the inquiry. The CQC has, again, found that the maternity services offered to families at Furness Hospital were inadequate.
2017 — East Kent Hospitals University NHS Foundation Trust
Recently fined £733,000 over a 2017 incident that led to the death of a week-old baby, the Trust is currently subject to ongoing investigations over a series of problems.
The Department of Health revealed that they have undertaken over twenty investigations in the past two years, five of which were about the deaths of mothers or babies. And earlier in the year, the trust revealed that over 100 babies had been left brain-damaged after being starved of oxygen during birth.
Most tragically, the Trust was aware of the problems, but failed to act. The Trust has admitted that a damning 2016 Royal College review of their maternity unit has largely been overlooked, just two of the twenty-three recommendations made in the report had been implemented by the Trust.
2000-2018 — Shrewsbury and Telford Hospital NHS Trust
This was perhaps the biggest maternity scandal ever seen. Although the inquiry focused on over 1000 serious incidents that had occurred since 2000, it found the culture that enabled them could be traced back even further, to the 1970s. While impossible to know for certain, there could have been hundreds of mothers and babies who were harmed unnecessarily.
The inquiry found that a push to keep Caesarean rates low meant that mothers were frequently ill-informed, and the Trust failed to manage complex issues. To compound the problems, mistakes continued to be made because the Trust did not investigate incidents.
2010-2020 — Nottingham University NHS Trust
Nottingham recently featured in a joint investigation by Channel 4 and The Independent, which found that over a ten-year period there had been at least 46 incidents resulting in brain damage to babies and 19 stillbirths.
The investigation found that the services were chronically short-staffed, but management were deaf to concerns raised by front-line staff. The consequence was a pressured service where mistakes were inevitable, but lessons were never learned, resulting in many more avoidable tragedies.
Areas of medical negligence in childbirth: 10 Years of negligence claims
In a report of analysed ten years of maternity claims with an incident date between 1 st April 2000 and 31st March 2010 i.e. 5,087 maternity claims with a total value of £3.1 billion, the key areas of maternal and childbirth negligence were identified:
1. Anaesthetic Issues: These claims included adverse incidents that had occurred in labour and during caesarean section.
2. Antenatal Care:
3. Antenatal Investigations: These included claims related to ultrasound scans and other antenatal investigations.
4. Bladder: These bladder injury claims are related to both surgery and vaginal delivery.
5. Caesarean Section: These claims included alleged delay in undertaking the procedure as well as claims where a complication of the procedure had occurred.
7. CTG Interpretation: The claims related to CTG Interpretation, during both the first and second stages of labour.
8. Drug Error: The information on the NHSLA database indicates that the drugs involved in the errors are often those commonly used in midwifery and obstetric practice i.e. Pethidine, Syntometrine, Syntocinon and antibiotics.
9. Management of Labour
10. Maternal Death
11. Midwifery Care
12. Operative Vaginal Delivery: Most of the claims involved operative vaginal delivery with the remainder involving forceps deliveries and Ventouse deliveries.
13. Perineal Trauma: These claims involved labial, 1st or 2nd-degree tears or episiotomies and 3rd or 4th-degree tears.
14. Postpartum Haemorrhage: These claims included those where there appeared to be a clear link to retained products, somewhere the haemorrhage appeared to be primary, and a few where the exact cause was not clearly recorded.
16. Retained Swabs: These claims occurred following both operative and vaginal deliveries.
19. Uterine Rupture
Claiming compensation for childbirth negligence
If you feel that the care you or your child received prior to, during or after birth was negligent, you may decide to bring a claim in order to secure justice and compensation for your and your child’s injuries. Speak to one of our medical negligence solicitors who specialise in birth injuries.
Devonshires Claims support victims of medical negligence by providing:
- A free no-obligation case evaluation
- A no win no fee agreement
- A network of medical experts and specialist medical negligence barristers
- Over 20 years’ experience in securing justice and compensation