The GMC has published data showing that more than a quarter (27%) of obstetrics and gynaecology trainees are ‘hesitant’ to escalate a patient’s care to senior colleagues.
This reveals an unhealthy and unhelpful culture of fear within the NHS and poses a serious risk to a rising number of mothers who require experienced staff to deliver their baby safely.
Sadly, there are too many incidents when a catastrophic outcome such as a stillbirth, a baby dying shortly after birth or suffering irreversible brain damage, occur as a result of delayed medical intervention following a normal pregnancy.
Arguably, those most at risk will be the mothers with pregnancies that are considered as low risk. In these cases, it is vital that diligent care is provided by the right medical professionals ensuring that unexpected red flags can be picked up and addressed in an appropriate and timely manner.
This means that it is critical that if signs that a baby is in distress, or other symptoms indicating that medical intervention may be required, become evident staff must quickly escalate a mother’s care to senior medics. When a pregnancy or delivery suddenly becomes more complicated, it is crucial that experienced consultants are available and more junior colleagues quickly alert them to a patient in order to mitigate the potential risks of serious harm.
Recent figures published by the National Maternity and Perinatal Audit (NMPA) have revealed that the number of babies delivered via a caesarean section sharply increased to nearly 39% of all births in 2023 – a 14% increase from the period 2015-2016 when a quarter of all babies born in the UK were delivered via the surgical method.
NMPA’s report also found that more than half (50.6%) of all births required medical intervention including c-sections and births assisted by instruments such as forceps.
Experts have pointed to a number of factors for the rise in complex births including mothers waiting to have children at an older age, obesity and pre-existing medical conditions.
The data reinforces the growing need for maternity units to have experienced staff available. Junior colleagues and wider staff members must know when to escalate a patient’s care and to do so without delays that may cause preventable catastrophic outcomes.
According to NMPA, 23.1% of c-section births were under emergency conditions while 16.4% were elected caesareans. This presents a worrying picture of a growing number of families who will be reliant on diligent care provided by experienced maternity staff.
As a national maternity review gets underway – firstly looking at 14 NHS Trusts in England – and the head of the General Medical Council (GMC) recently pointing to a toxic culture within the NHS, mothers and babies are potentially at a higher risk of suffering significant birth injuries.
The national maternity review will initially investigate the maternity services in the following locations:
- Morecambe
- Blackpool
- Bradford
- Leeds
- Shrewsbury
- Birmingham
- Gloucester
- Leicester
- Norfolk
- Oxford
- Romford
- Sussex
- Yeovil
- East Kent
The number of hospitals involved covering a range of locations up and down the country indicates that there are systemic failings within NHS maternity departments.
The review follows high profile investigations into the maternity services delivered in Morecambe, Shropshire, East Kent and an ongoing current review in Nottingham. It is likely that the failings found in the reviews already undertaken will be mirrored following the conclusion of the national investigation.
In the meantime, mothers may find themselves in the care of inexperienced staff lacking the confidence to alert senior colleagues to potentially dangerous developments.