Maternity issues are now one of the biggest challenges facing hospitals in England and Wales. Failings in medical care in maternity units across the country are coming to light as serious patient safety concerns, many of which have been exposed as dating back for decades, are being identified.
The recently reported incidents of avoidable harm in Shropshire’s maternity services are arguably the most high-profile incidents where patient safety has fallen well below acceptable standards. Led by midwife Donna Ockenden, the review into the patient care delivered to mothers and babies revealed serious medical errors had occurred over a 20-year period.
Poor patient safety led to catastrophic outcomes
The widely reported patient safety investigation in the county found that around 300 babies had unnecessarily died, or suffered permanent brain damage, during this time.
Many failings were identified as leading to these catastrophic birth injuries with the main driver impacting patient safety being the hospitals’ commitment to promoting natural births.
The Shropshire maternity scandal investigation found that maternity care at the hospitals in the county heavily supported vaginal births – sadly at the cost of patient safety for many families.
Push on natural births identified as a patient safety risk
A natural birth is not the safest option in all circumstances. When both mother and baby are carefully monitored throughout a pregnancy and birth, red flags may occur during the pregnancy and before, during and just after the baby is born.
In some cases, a timely emergency c-section is the only option to ensure patient safety for both mother and baby and to prevent birth trauma.
When red flags present after childbirth, such as signs of a Group B Strep infection, the timeliness of medical care is crucial to mitigate the risks of patient harm.
Patient safety culture requires improvement
The maternity scandal in Shropshire is sadly one of many. Before medical negligence on a large scale was exposed in Shrewsbury and Telford, maternity failings in Morecambe Bay had been reported as the first maternity scandal in the history of the NHS. The hospitals delivering maternity services in Nottingham; Merthyr Tydfil, Llantrisant and Bridgend in south Wales; and Ashford and Margate in East Kent, have also been subject to patient safety investigations.
Minimising the risks to patient safety
Maternity care should be focused on ensuring patient safety first. Circumstances when medical intervention is the only appropriate course of action is when medical staff recognise that a baby is in distress. In some instances, the baby may be too large to safely deliver vaginally.
For some pregnancies, a caesarean procedure is the only viable option to minimise the risks of a catastrophic birth injury.
Ensuring the appropriate team of health professionals are involved during a pregnancy and childbirth is critical to mitigating the risks leading to avoidable harm.
When patient safety falls below acceptable levels
During a pregnancy and childbirth, when health professionals fail in their duty of care to patient safety, the outcome is devastating, and permanent.
Patient harm, leading to irreversible brain damage causing permanent disabilities such as cerebral palsy, impacts the entire family.
Serious birth injuries can lead to brachial plexus injuries like erb’s palsy. Babies that have suffered a lack of oxygen during the labour and birth can also have wider complex needs including behavioural issues, epilepsy and learning difficulties.
Common errors causing avoidable harm
Mothers and babies suffer serious birth injuries as a result of repeated inadequate patient safety culture including:
- Healthcare professionals not communicating with each other. For example, a midwife failing to escalate a critical situation to an obstetrician
- Failing to adequately monitor both mother and baby. This leads to signs that a baby is in distress being missed causing a lack of oxygen, resulting in irreversible brain damage
- Failing to follow NICE guidelines on safely manoeuvring a baby during childbirth in circumstances when they are in breech position or the baby’s shoulder gets stuck.
Medical negligence can result in erb’s palsy, otherwise known as a brachial plexus injury
- Failing to diagnose and treat the common, and symptom free, Group B Strep infection in a timely manner. This can mean that a baby that could have been easily treated suffers permanent brain damage instead
- Health professionals ignoring a mother’s concerns until it is too late
- Junior medical personnel not recognising, or escalating, patient care when a pregnancy and labour becomes complicated. Failing to alert a more senior health professional in a timely manner, or not at all, can lead to catastrophic birth injuries
Maternity care requires improvement across England and Wales
Since the Morecambe Bay maternity scandal in 2015, maternity issues in other hospitals across the country are being identified. Hospitals in East Kent, Nottingham, Sheffield and south Wales are just some areas where maternity services are being scrutinised.
A common finding has been that the culture amongst maternity care staff requires improvement. For the families affected by poor maternity care, the failure of medical staff to listen to the mother during her pregnancy and up to, and during, labour, is a recurring concern.
Improving maternity care by listening to families
Reports from the families being represented by the catastrophic birth injuries team at Diane Rostron, and wider accounts from families impacted by inadequate patient safety, have echoed that midwives, and other medical personnel in maternity units, are simply not listening.
Other cultural issues raised by investigations into different NHS Trusts’ maternity services include serious incidents not being reported, nor properly investigated to prevent further risks to patient safety.
The lack of adequate communication between staff, specifically in high-risk maternity care situations, is sadly another repeated maternity issue leading to preventable baby deaths and avoidable brain damage at birth.
While giving birth is the most natural thing in the world, and despite advances in medicine and medical practice and facilities, risks remain during a pregnancy and birth.
Preventable patient safety risks
For some women, a pregnancy may have progressed as low risk. Maternity staff must remain vigilant right through to when the baby is delivered safely as unpredictable situations, such as the baby being in breech, or a Group B strep infection, will require timely maternity care.
In these circumstances, communication between maternity staff is critical. High risk situations may suddenly occur and, in the absence of timely intervention by appropriately experienced maternity staff, may lead to serious failings in patient safety.
Birth trauma, including catastrophic birth injuries, stillbirths, and neonatal deaths, are the tragic patient outcomes when health professionals fail in their duty of care.
Medical negligence leading to serious birth injuries
Significant birth injuries can also lead to avoidable stillbirths and neonatal deaths. The families that are impacted by unsafe maternity care not only suffer the loss of a much-loved baby, but also experience the profound lifelong trauma of knowing it could have been avoided with better maternity care.
Inadequate patient safety in maternity settings can cause irreversible brain damage with cerebral palsy and other lifelong disabilities the outcome for families who deserve better medical care.
Promised improvements in maternity care
The government has pledged more funding, more training, and more midwives in order to tackle the growing maternity scandal in England and Wales.
For the families who have lost a baby as a result of medical negligence, and for parents who are struggling to manage the complex needs of their child following a catastrophic birth injury, it is too little, too late.
For some expectant mothers, the prospect of giving birth at their local hospital is a terrifying thought with poor patient safety being exposed all too often.
Compensation following preventable patient safety failings
Families who have lost a child as a result of what is believed to be an avoidable birth injury, or a serious birth injury resulting in permanent disability, are entitled to compensation.
Birth injury compensation considers the needs of the child from birth, and for the rest of their lives.
It provides families with peace of mind that their child’s complex needs can be met with the appropriate quality of care. Home adaptations, or a new home if more suitable, is accounted for.
Specialist equipment such as wheelchairs and other aids are considered when a good birth injury solicitor calculates the correct compensation amount.
Birth injury claims are hard fought however, and the law places the burden of proof on families. In order to access birth injury compensation, it must be proved that the injury could have been prevented in the absence of medical negligence.
Instructing the right birth injuries solicitor to fight your corner
Birth injuries compensation is a complex area of law. It requires a specialist birth injury lawyer with a team of independent medical experts and specialist barristers to deliver the right outcome for families.
We fight for birth injury compensation when patient safety has fallen below acceptable standards
The team of birth injury experts at Diane Rostron will fight to ensure that your voice is heard. The team will fight to secure the right level of compensation to provide families with peace of mind.
We understand the medical complexities of birth injury claims and what is required to win these robustly fought cases.
Listen to other families who have suffered a birth injury
Hear more from some of our birth injuries clients and other medical negligence stories. We have a strong track record of winning £multi-million birth injury claims and leave no stone unturned.
The legal process for birth injury compensation claims will not be easy, and it can take several years to conclude for some families. We understand that a child that has suffered a significant birth injury resulting in complex disabilities requires appropriate care sooner rather than later.
Interim payments during the compensation process
We fight hard to secure interim payments easing some of the pressure on families while their claims process proceeds.
Our birth injury experts are here to listen, and to help.