Maria Repanos of Hudgell Solicitors’ Medical Negligence Team
By Legal Futures Associate Hudgell Solicitors
A law firm acting for mothers, children and families who have suffered as a result of birth injuries has told a parliamentary inquiry it is witnessing a “surge” in cases.
In a submission to the Westminster inquiry into the reasons behind an increasing number of birth trauma incidents across England, Hudgell Solicitors has told MPs the number of potential clients who believe their NHS maternity care was substandard continues to increase.
“The number of inquiries we received during 2020 / 2021 increased dramatically,” said Maria Repanos, head of clinical negligence at the firm’s Manchester office.
“This sharp rise in inquiries has also, in turn, led to a surge in birth trauma cases that we have successfully settled during that period,” she added.
‘A Public Inquiry is imperative’
Hudgell Solicitors also told the All-Party Parliamentary Group (APPG) on birth trauma that a statutory Public Inquiry into England’s maternity services is now crucial.
“A Public Inquiry is more likely to bring about much-needed indelible change in this matter, which is clearly an issue of public concern,” said Ms Repanos.
“Through our work with clients, we firmly believe that the NHS’s failure to improve maternity safety is so startling that a public inquiry is imperative in order to ensure that women, babies and their families no longer come to any avoidable harm,” she added.
Hudgell Solicitors believes it is apparent from investigations already carried out, such as those undertaken by Donna Ockenden, that basic elements of safe care are not in place in a number of maternity units across England.
The APPG inquiry into birth trauma has been set up to investigate the causes of traumatic birth and to develop policy recommendations to reduce the rate of birth trauma. Research shows that:
- 4 to 5% of women develop post-traumatic stress disorder (PTSD) after giving birth.
- This affects around 25,000 to 30,000 women every year in the UK.
- A much larger number – as many as one in three – find some aspects of their birth experience traumatic.
- 53% of women who experienced birth trauma are less likely to have children in the future.
- 84% of women who experienced tears during birth, did not receive enough information about birth injuries ahead of time.
‘Recommendations are not enough’
Maternity negligence incidents remain the highest costs of compensation claims against the NHS in England, in addition the Care Quality Commission (CQC) rates around one in four maternity services as either “inadequate” or “requires improvement”.
The birth trauma experiences of women, clients of Hudgell Solicitors, are also included in the firm’s submission to the APPG.
Many came forward wanting to share their stories as part of Hudgell’s campaign for meaningful change.
As one mother, who had an emergency hysterectomy “to save her life” just hours after giving birth, said:
“Recommendations are not enough, because recommendations for change are not evidence of change.”
These women’s experiences detail the significant impact that negligent birth trauma has had on their lives which has left them with physical and psychological injuries, disabilities and had long-term effects on family relationships and finances.
More than 20 women submitted their experiences, saying:
Client A
“My little girl was stillborn. I was worried about my baby and I wasn’t listened to.
“I felt like I was treated as a pest. I had a condition which can be serious, but no one was concerned. We were that close to having Tilly and then we lost her, and it destroyed us.
“When I go to the cemetery and meet other families visiting their children’s graves, I hear similar stories just like mine.
“I would say to politicians that maternity services need proper staffing, and those staff need proper training, so more babies don’t die.”
Client B
“My birth led to a hysterectomy. I think I will always suffer emotionally from what has happened.
“I received conflicting advice from different consultants about the method of my delivery.
“I have since been told in my birth report that I should have been taken for an emergency C-section because my birth was high risk.
“It took over a year for the report to be completed.
“The decision was made to remove my uterus to save my life. I did not hold my baby until 48 hours after the birth.
“I could not physically care for my baby independently because of my operation or take care of myself when I did come home.
“I was affected emotionally and spent many days and nights crying.
“I would like to see mothers of high-risk pregnancies under consultant care, and to see the same consultant every time.”
Client C
“I suffered a miscarriage when 19 years of age.
“I do feel as though I was not listened to when I was trying to say things were not right during my labour.
“I have experienced severe anxiety especially when pregnant with my second son.
“I was not offered any mental health support at all following the birth trauma I experienced, I felt I was made to feel like I was silly for even questioning or asking for support. I would like to see women listened to when they say how their body feels.”
‘Systemic issues within maternity services’
Hudgell Solicitors, which represents clients at The Post Office Horizon IT, the Manchester Arena and the Covid-19 Public Inquiries, believes maternity units must be properly resourced with safe staffing levels and vital training being provided to those working within them.
In order for this to be prioritised, maternity budgets need to increase to support these improvements.
“We have supported many parents whose children have sadly been stillborn or died during the neonatal period due to failures of healthcare provision on maternity wards. We are well versed in understanding these complex issues and we are hugely sympathetic to our resilient clients upon whose lives birth trauma has had a profound impact,” said Ms Repanos.
“We therefore support the Maternity Safety Alliance’s position that individual national initiatives and policies, although useful, are insufficient to tackle systemic issues within maternity services.
“Upon the basis that the issues affecting maternity services appear to be systemic, a statutory Public Inquiry can create meaningful change so that families who have suffered can be at the heart of any significant decisions that are subsequently made.
“It is our hope that an inquiry dealing with maternity services would address widespread issues so that lessons are learned, and recommendations implemented resulting in significant improvements and positive change.”
The All-Party Parliamentary Group Inquiry
The evidence the APPG gathers will form a policy report which will include recommendations for the UK Government and is due to be published in Spring 2024. The inquiry’s objectives are to:
Identify common features in maternity care (antenatally, during labour and birth, and postnatally) that contribute to birth trauma.
Highlight examples of good practice, both in the quality of maternity care and in providing support to women who have had traumatic birth experiences.
Look at the impact of birth trauma on women’s relationships, ability to bond with their baby and future decision-making (e.g. whether to have another baby, whether to return to work).
Find out whether current postnatal services to diagnose and treat women’s physical and mental health problems are up to scratch. This would include, for example, looking at whether severe obstetric tears are being diagnosed promptly, whether mental health problems are being identified at the six-to-eight-week check, and whether perinatal mental health teams are accepting and treating women within an appropriate time frame.
Develop parameters for understanding the possible economic cost of birth trauma, with a view to informing future research.
Influence government policy by identifying areas where maternity care could be improved to minimise birth trauma and by highlighting ways in which postnatal support can be optimised to meet women’s physical and psychological needs after traumatic birth.”
