The All-Party Parliamentary Group on Birth Trauma has published its Birth Trauma Inquiry report, ‘Listen to Mums: Ending the Postcode Lottery on Perinatal Care’, highlighting the impact of poor maternity care throughout the UK.
Birth trauma can be defined as “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 well-being.”
MP Theo Clarke obtained written submissions from over 1,300 members of the public recounting, in some detail, their first-hand experiences of pre- and post-natal care. The Health Minister, Maria Caulfied has now apologised to women having heard their harrowing accounts.
The issues surrounding injury during childbirth are becoming more and more prevalent with TV Star Louise Thompson speaking openly about how her childbirth experience “ruined her life” after she suffered a traumatic delivery when her son’s head became stuck in her pelvis and she required an emergency caesarean. This followed her being denied an elective caesarean delivery. Louise has spoken about the impact that the trauma had on her initial months of parenthood and the psychological impact that the experience had on her and her family.
Staggeringly, the APPG Inquiry reports that almost a third of women experience a traumatic birth every year, and between 4-5% of these women develop post-traumatic stress disorder (PTSD) because of their experiences. One in 25 women will be diagnosed with PTSD but many more will not meet the full criteria for this diagnosis, nevertheless they will develop symptoms of psychological distress such as intense anxiety.
One of the major concerns that the Inquiry has highlighted is the failure of hospital staff to listen to patients when they reported that something was wrong during labour. The first-hand accounts repeatedly refer to patients being made to feel they were exaggerating, being ‘overly anxious’ or dismissed entirely.
These failures have directly contributed to traumatic labours resulting in injury to both women and children. The report highlights that too frequently, ‘red flags’ are reported by mothers but are missed or ignored by hospital staff.
Additionally, many written submissions described how the experience of birth trauma was made worse by a failure of hospitals to deal sensitively with complaints about poor care.
One of the first had accounts given to the Inquiry referenced that the hospital had repeatedly dismissed one women’s diagnosis of PTSD following the delivery of her child and went so far as to state that a person suffering from PTSD would not have been capable of making the formal complaint which they had received.
The Inquiry recognises that the highest rate of litigation in clinical negligence practice is for childbirth injuries and the value of maternity claims has doubled in the last 6 years. In 2022/2023 the total cost of maternity payouts was £1.1 billioni. Additionally In 2006/2007 the average maternal injury claim was worth approximately £82,011 and in 2022/2023 it averaged at £301,492.
Another worrying feature uncovered by the Inquiry was the reports of lack of appropriate consenting procedures in maternity care, particularly during the use of instruments to aid delivery.
The law states that to provide consent, a patient must be aware of the risks involved with the particular treatment being offered. The doctor must explain all reasonable alternatives (and the risks involved) to the patient. However, the doctor is not obliged to tell a patient about treatments which the doctor does not consider to be reasonable. A doctor cannot simply inform a patient about the treatment option or options that the doctor himself or herself prefers.
The Inquiry states that no procedure should be carried out on a woman without her consent, other than in an emergency.
The report goes on to state that:
“All pregnant women should have the opportunity to access good quality antenatal education that explains, clearly and straightforwardly, what giving birth involves, what the risks are and the kinds of choices they might have to make during labour so that they can think them through beforehand. Women should also have access to a risk calculator that helps them understand their own individual risk profile and to make choices about their birth accordingly”.
What does good care look like?
The Inquiry makes some recommendations for the maternity sector, focusing on the provision of post-natal support for women following childbirth.
In particular, the inquiry looks to support those who disclose that they have had a previous traumatic experience (including traumatic birth) and recommends they should be offered trauma-informed care, including the opportunity to receive mental health support from a professional and the opportunity to discuss potential triggers, and how they can be avoided, with the obstetric team.
Again, staffing has been highlighted as the major obstacle in improving maternity care throughout the country. This applies to both prenatal and post-natal care, with women who have experienced trauma waiting six months to see a psychologist.
Gill Walton, president of the Royal College of Midwives, told the Inquiry a ‘fully staffed and highly trained workforce that have time to work with women antenatally to provide the right care during labour and birth’ is a prerequisite to preventing birth trauma.”
The Birth Injury Trauma Report calls for an overhaul of maternity services to stop the “postcode lottery” in maternity care.
If you feel you have been subject to negligent care during your pregnancy or delivery, please contact us for further advice.
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This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2024
