Postcode lottery of maternity services highlighted in new report

A health minister has apologised after a new report concluded that poor care in maternity services is “frequently tolerated as normal”.

The parliamentary inquiry into birth trauma is calling for a national plan to improve maternity care, as it claimed women are often “treated as an inconvenience”.

Health minister Maria Caulfield said that maternity services “have not been where we want them to be” when she was challenged about the findings of the report.

The all-party inquiry, led by Conservative MP Theo Clarke and Labour MP Rosie Duffield, called for the creation of a maternity commissioner reporting to the prime minister.

Ms Clarke, who pushed for the inquiry after saying in Parliament that she felt she was going to die after giving birth in 2022, said there is an unacceptable “postcode lottery on maternity services”.

The inquiry heard from 1,300 people who had experienced a traumatic birth and described their stories as “harrowing”.

“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 authors wrote.

“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 shared stories of being left in blood-stained sheets, or of ringing the bell for help but no-one coming.

“We also heard from maternity professionals who reported a maternity system in which overwork and understaffing was endemic. Some referred to a culture of bullying.

“The picture to emerge was of a maternity system where poor care is all too frequently tolerated as normal, and women are treated as an inconvenience.”

Ms Clarke told The Times: “We have listened to mums carefully and applaud their bravery in coming forward, sometimes with horrific testimony of how the system failed them and the mental, physical and economic cost of that failure.

“The raft of recommendations we make, especially the appointment of a maternity commissioner, are all designed to end the postcode lottery on maternity services.”

She told BBC Radio 4’s Today programme: “I think what came through very strongly (in the inquiry) was that there does seem to be a postcode lottery for maternity care in this country, and that’s something that I don’t think is acceptable, that depending on where you live, you will literally be offered a different level of care in terms of how you’re given support during childbirth and afterwards.”

Describing her own experience, she added: “I remember pressing the emergency button after I’d come out of surgery and a lady came in and said she couldn’t help me, said it wasn’t her baby, wasn’t her problem and walked out and left me there – so we need to make sure there are safe levels of staffing.”

She told Times Radio: “We absolutely recognise what’s in the report. We are on track with rolling out some of these services to prevent this from happening in the first place but, when it does, better look after women.”

Asked on Sky News whether there was an apology to be made to those affected by birth trauma, Ms Caulfield said: “Absolutely. I recognise as women’s health minister that maternity services have not been where we want them to be.”

Ms Caulfield cited mental health support teams across England for new mothers, and pelvic health services and an increase in the number of midwives.

And she said that the culture of “natural birth being the best birth” is changing and “mums should be getting a better experience and often that leads to safer births and better outcomes”.

The report authors also called for more midwives and maternity staff, for new mothers and babies to have separate health checks at six weeks so the doctor can fully assess the mother’s mental and physical health and additional efforts to reduce the risk of birth injuries.

They made recommendations about providing more information on birth choices for women and informing them about the risk of injuries in childbirth.

The authors also called for women’s choices about giving birth and access to pain relief to be “respected”.

Meanwhile they said that the time limit for medical negligence litigation relating to childbirth should be extended from three years to five years.

Gill Walton, chief executive of the Royal College of Midwives, said: “Sadly, not all birth experiences are positive and poor experiences can have a devastating impact on women and should be taken very seriously as a threat to maternal mental and physical health and infant wellbeing.

“Undoubtedly staffing shortages drastically impact the safety and quality of care that midwives can and so want to deliver. Our own members tell us they are struggling to give women the time and quality of care they need and deserve.

“Also, with the rise in more complex pregnancies, having the right skill mix of staff on shift is key.

“Access to appropriate training has also been highlighted in this report and when there aren’t enough midwives, crucial training is often postponed and this impacts how prepared staff can be for not only emergency situations, but how improvements in day-to-day maternity care can be achieved.”

Health Secretary Victoria Atkins said she was “determined to improve the quality and consistency of care for women throughout pregnancy, birth and the critical months that follow”.

In January, she described her personal experience of the “darker corners” of the NHS after giving birth as a patient with type one diabetes.

NHS England chief executive Amanda Pritchard 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 that NHS England was working with local health bodies so “their teams can create and nurture a culture where women are listened to, their choices respected and care is personalised, equitable and safe”.

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