National Maternity Investigation Uncovers Deep-Rooted Failings in NHS Care
A damning interim report from a national investigation into England's maternity services has revealed profound and systemic issues affecting women and babies, including insensitivity from staff, racism, discrimination, and chronic staff shortages. Published on Thursday, the findings highlight a crisis in care that demands urgent attention and reform.
What Is the National Maternity and Neonatal Investigation?
Launched in June by Health Secretary Wes Streeting, the investigation is led by Lady Amos and aims to address what Streeting described as the "systemic causes of unacceptable care affecting women, babies, and families." Through public evidence calls and expert panels, it seeks to establish national recommendations to enhance maternity and neonatal care and safety across the country. Additionally, it focuses on persistent inequalities faced by women from ethnic minority and deprived backgrounds, including local investigations at 12 NHS trusts. The full report is scheduled for release this spring, following initial impressions in December and the recent interim findings.
Why Was the Investigation Launched?
The investigation follows a series of high-profile maternity failings across multiple NHS trusts. Key incidents include:
- A five-year review by midwife Donna Ockenden into 1,862 cases at Shrewsbury and Telford NHS trust, which found that hundreds of babies died or suffered brain damage due to inadequate care.
- Nottingham University Hospitals NHS trust was fined £1.6 million in February last year after admitting failures in care that led to the deaths of three babies within months.
- In 2024, the UK's first inquiry into birth trauma revealed that women were often ignored by midwives and doctors, resulting in permanent damage and post-traumatic stress disorder for many.
Current State of Maternity Care in England
The maternal death rate in the UK has risen to 12.8 deaths per 100,000 maternities, a 20% increase from 2009-11, when the government aimed to halve it. Inspections by the Care Quality Commission show that over a third (36%) of NHS maternity services require improvement, with more than one in ten (12%) deemed inadequate. Inequalities are stark: Black women are three times more likely to die during childbirth than white women, and women from the most deprived areas face twice the mortality risk compared to those from affluent backgrounds.
Responses from Bereaved Families and Advocates
While some families have welcomed the investigation, others argue it is insufficient and call for a statutory inquiry. The Maternity Safety Alliance, led by bereaved women, describes the government's approach as "performative" and criticizes the initial reflections for minimizing the severity of avoidable harm in NHS services. They advocate for a judge-led statutory inquiry to ensure accountability and transparency.
New Findings and Next Steps
The interim report reinforces concerns about inadequate staffing and details how many families have experienced "cover-ups" and a lack of transparency from NHS trusts when seeking answers about birth trauma and baby loss. The investigation is set to conclude this spring, with two final reports expected to provide comprehensive recommendations and reflections to drive meaningful change in maternity and neonatal care across England.
