Maternity care is one of the most important aspects of healthcare for expectant mothers. The journey from pregnancy to childbirth and beyond can be both exciting and challenging.
In England, the NHS oversees maternity services. In Wales, the responsibility is shared between the NHS and the Welsh government. Maternity reviews inspect all aspects of care to ensure patient safety.
Sadly, a growing number of hospitals are falling short of acceptable standards of care leaving too many families seriously harmed following avoidable medical errors.
What are maternity reviews?
Maternity reviews are comprehensive evaluations of the maternity services provided. They focus on a range of factors including the quality of care, safety, accessibility, and the overall experience of mothers during pregnancy, childbirth, and the postnatal period.
The aim of these inspections is to investigate all aspects of care to identify any areas for improvement. This is to ensure that safe maternity care is delivered for both mothers and their babies.
There are two main types of maternity review:
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- National reviews: These are large-scale assessments that look at maternity care across the country. They are usually conducted by external bodies, such as the Care Quality Commission (CQC) or independent inquiry commissions. Twelve hospitals in England are currently part of a recently launched national maternity review.
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- Local reviews: These are specific to individual NHS Trusts and are often initiated following consistent campaigning by families who have lost their baby or whose child has suffered significant harm in what is believed to be preventable circumstances. A number of high profile local reviews have been conducted or are ongoing within the past 15 years including in Morecambe Bay, Shropshire, Nottingham, East Kent, Cwm Taf in south Wales and Leeds.
Why are maternity reviews important?
Maternity reviews play a vital role in not only shaping the future of maternity care but also in ensuring that repeated failures are learned from. They help identify:
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- Strengths and concerns in the existing systems and procedures
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- Safety concerns, such as hospitals acting in breach of national guidelines
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- Evidence of ongoing and appropriate training, fit for purpose escalation processes and adequate resources to deliver high standards of patient care
Given the importance of maternity care, the reviews aim to address several key areas. Some of these include:
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- The effectiveness of communication between staff and patients. This includes how well a hospital listens and acts on patient concerns
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- The adequacy of staffing levels – both in terms of numbers and an appropriate combination of seniority and experience
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- Adequate recording of medical records – essential for patient care and also as a critical aid in identifying key learnings following serious harm incidents
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- The quality of communication between maternity staff and evidence of adequate escalation processes in emergency situations
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- Up to date training and evidence that maternity staff consistently follow national guidelines
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- The quality of care delivered during a pregnancy and up to a baby’s birth and neonatal period
How do maternity reviews impact women and families?
Maternity reviews, including those already finalised in Morecambe Bay, Shropshire, Cwm Taf in south Wales and East Kent, alongside ongoing and newly launched investigations in Nottingham, Leeds and a national review covering 12 NHS Trusts, provide affected families with the opportunity to be listened to.
For expectant mothers, maternity reviews can be unsettling for fear that they may be let down by their healthcare provider.
What happens after a maternity review?
The reviews published to date have raised serious concerns and highlighted repeated failings leading to avoidable catastrophic incidents such as stillbirths, neonatal deaths and permanent brain damage causing a loss of mental capacity.
While the findings of the investigations to date have identified clear areas for improvement with robust recommendations, the necessary changes are not taking place quickly enough for families.
Ten years after the publication of the Morecambe Bay review findings, the same failings were found to have led to the preventable death of baby Ida Lock.
What do I do if I am too scared to have my baby at my local hospital?
It is important to know that most mothers and babies experience diligent care throughout a pregnancy, birth, and neonatal period.
Only a minority of families are seriously harmed by avoidable medical errors. This does not minimise the concerns of expectant mothers however, and we have clients who have made the decision not to have their baby at their local hospital as a result of understandable concerns.
It is helpful to understand the level of care you should expect from your hospital. Asking questions around how they would mitigate the risks of unexpected emergencies, and their processes for escalating patient care in these circumstances, can help provide peace of mind before the big day.
What should I do if I am worried about my baby’s development?
It is important to discuss any concerns with your healthcare provider initially. If you suspect that your baby is missing key milestones or noticed that your baby exhibited unusual behaviour after their birth – like making grunting noises and they were pale and floppy – we can help.
You can read more about the symptoms of a serious birth injury here.
I am scared to take legal action against my hospital while my child continues to be cared for
We understand the worry that ongoing medical care may be impacted following the launch of a medical negligence claim against the same hospital.
Families can be reassured however, that pursuing a birth injury claim should not affect the quality of any ongoing medical care that a hospital has a duty to provide.
Our experts have answered more frequently asked questions here.
I think my hospital is lying to me about my baby’s injuries
Every family who has lost their baby, or whose baby has suffered a catastrophic brain injury, is entitled to fully understand why this has happened.
A hospital should conduct its own internal review to find out what happened following an incident of serious harm.
Clear and honest answers should be provided however, the sad reality is that many families are left in the dark.
What happens if my medical negligence concerns are wrong?
Our experienced birth injury specialists can quickly identify whether a case is worth investigating. Families will be advised relatively quickly after making an enquiry if we do not believe that they may have a claim for a preventable and significant birth injury such as a stillbirth, neonatal death, or irreversible brain damage.
In our extensive experience, families’ instincts about poor care resulting in catastrophic outcomes are often right.