Birth Trauma Inquiry: medical negligence lawyer welcomes report's publication and examines the 12 recommendations designed to improve maternity care

This year the All-Party Parliamentary Group (APPG) on birth trauma set up an inquiry to investigate the reasons for traumatic birth and to develop policy recommendations to reduce the rate of birth trauma. 

As someone whose life was significantly affected by birth trauma during the birth of my first child it was powerful to be asked to give evidence at the inquiry. 

However, as I shared my experiences of not being listened to, of fear and then the devastating injuries both my daughter and I sustained I couldn’t help but sadly reflect that 15 years after my own birth trauma we were still hearing similar stories of pain and loss. 

The publication of the Birth Trauma Inquiry today draws a line in this. It’s an attempt to break the taboo around birth trauma and to introduce a base standard in maternity services across the United Kingdom. 

What are the Birth Trauma Inquiry's 12 recommendations?

The APPG on Birth Trauma is calling on the UK Government to publish a National Maternity Improvement Strategy, led by a new Maternity Commissioner who will report to the Prime Minister which will outline ways to:

1. 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.
    
2. Provide universal access to specialist maternal mental health services across the UK to end the postcode lottery.
    
3. Offer a separate six-week check post-delivery with a GP for all mothers which includes separate questions for the mother’s physical and mental health to the baby.
    
4. Roll out and implement, underpinned by sufficient training, the OASI (obstetric and anal sphincter injury) care bundle to all hospital trusts to reduce risk of injuries in childbirth.
    
5. Oversee the national rollout of standardised post birth services, such as Birth Reflections to give all mothers a safe space to speak about their experiences in childbirth.
    
6. Ensure better education for women on birth choices. All NHS Trusts should offer antenatal classes. Risks should be discussed during both antenatal classes and at the 34-week antenatal check with a midwife to ensure informed consent.
    
7. Respect mothers' choices about giving birth and access to pain relief and keep mothers together with their baby as much as possible.
    
8. Provide support for dads and ensure nominated birth partner is continuously informed and updated during labour and post-delivery.
    
9. Provide better continuity of care and digitise mother’s health records to improve communication between primary and secondary health care pathways. This should include the integration of different IT systems to ensure notes are always shared.
    
10. Extend the time limit for medical negligence litigation relating to childbirth from three years to five years.
     
11. Commit to tackling inequalities in maternity care among ethnic minorities, particularly Black and Asian women. To address this NHS England should provide funding to each NHS Trust to maintain a pool of appropriately trained interpreters with expertise in maternity and train NHS staff to work with interpreters.
     
12. The National Institute for Health and Care Research to commission research on the economic impact of birth trauma and injuries, including factors such as women delaying returning to work.

Recommendations can have a significant impact on improving maternity safety 

Each of these recommendations will have a significant impact on maternal outcomes. It’s imperative that mothers are given good quality ante-natal education and to be informed of their own risk profile. 

Had I been advised of my significantly higher risk of sustaining a severe perineal injury as a first-time mother of South Asian origin my injuries may have been avoided and the past 15 years would have been so different. 

Poor outcomes for ethnic minority women and the need to tackle inequalities 

I’m therefore particularly pleased to welcome as a priority tackling inequalities in maternity care among ethnic minorities. We have known for many years that Black, Asian and Minority Ethnic women all experience disproportionately poor outcomes in maternal and neonatal care. They are at higher risk of complications such as maternal death, poor maternal outcomes, stillbirth and preterm birth. 

In particular the failure to recognise language difficulties is a barrier which leads to a lack of informed consent, a basic and fundamental right of every woman in childbirth. Often against policy guidelines vital information is still translated by family members due to a lack of appropriate translation services.

 Irwin Mitchell plans first South Asian Maternal Health Conference

On 28 June, 2024, Irwin Mitchell is holding the inaugural South Asian Maternal Health Conference at the Royal College of Obstetricians and Gynaecologists to examine the maternal health disparities that South Asian women face and to find innovative and meaningful ways to achieve equity in maternity care. 

I'm honoured that Ranee Thakar, President of the RCOG and Theo Clarke MP will be speaking and further sharing the findings of the Inquiry.

OASI care bundle needs to be implemented

It’s also vital that the OASI (obstetric anal sphincter injury) care bundle is rolled out and implemented to reduce the rate of these often permanent and life-altering injuries that leave women with a lifetime of pain and bowel incontinence. 

The most recent available figures suggest that 3.1% of all vaginal births result in an OASI, roughly 14,000 a year in the UK. This is likely to be an underestimate as so many tears are missed, a theme we see often. 

A survey of 325 women by The MASIC Foundation found that 85% believed the injury had affected their relationship with their child and many said it had seriously impacted on their ability to return to work. 

Our work supporting families affected by birth trauma

Where things do sadly go wrong it’s vital that women are listened to and their concerns investigated. 

Through our work supporting clients affected by birth trauma, mums often tell us that they don’t feel their concerns have been properly listened to and investigated. It’s important to help provide them not only with the answers they deserve, but access to the specialist treatment and support they may require to try and overcome their injuries, 

With the support of my firm, I'll continue to work with the APPG on Birth Trauma and advocate for injured women collaborating with our charitable partners, health care professionals and policy makers to create long-lasting and practical changes to in maternity care. 

Behind the lived experiences submitted to the Inquiry are years of pain, loss, trauma and injuries. We’re more than just statistics. It’s now time that decisive and meaningful action is taken to finally address issues in maternity care.

Find out more about Irwin Mitchell's expertise in supporting mums affected by birth trauma at our dedicated birth injuries section.