Women let down by maternity service

The stories shared during the Birth Trauma Inquiry, published last month, are sadly all too familiar to us. We see the same issues arising year after year with little sign of learning from mistakes.

 

The findings outlined in the report are deeply concerning, highlighting common themes. These include a failure to listen to women, lack of informed consent, poor communication, lack of pain relief, lack of kindness, problems with breastfeeding, and poor postnatal care. Women from marginalised groups, particularly those from minority ethnic groups, appeared to experience particularly poor care, with some reporting direct and indirect racism. The inquiry also heard from maternity professionals who reported a maternity system in which overwork and understaffing were ‘endemic’.

 

A series of inquiries have already been conducted to attempt to address failures in maternity care: the Morecambe Bay Investigation in 2015; the Ockenden Review in 2022; the independent investigation into maternity and neonatal services in East Kent in 2022; and a fourth investigation is currently under way into claims that hundreds of babies and mothers were harmed by poor care at Nottingham University Hospitals NHS trust.

 

Every year, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries prepares a report that looks at maternal deaths in the UK. The 2023 report concluded that women from Black ethnic backgrounds are four times more likely, and women from Asian ethnic backgrounds are twice as likely to die during pregnancy and childbirth. The NHS has been aware of this disparity for many years.

 

There is little sign that the multiple inquiries have led to a meaningful change in the delivery of services. The report asks the government to outline how it will recruit, train and retain more midwives, obstetricians and anaesthetists to ensure safe levels of staffing in maternity services. Without addressing the issue of retention and recruitment, improving care will be challenging.

 

We admire the courage of the women and families who have bravely shared their stories. Their experiences are invaluable and must not be overlooked. It is time for a centrally led overhaul of maternity services in the UK.

 

Jon Crocker

Managing partner and head of clinical negligence and personal injury, Bindmans, London

 

Prisons and short-term sentences

On 15 May the Ministry of Justice announced the implementation of ‘Operation Early Dawn’ to slow the transfer of defendants from police cells to magistrates’ courts and onwards into prison. Any discussion about the increasing prison population is often followed by a proposal that sentences of one year or less should be restricted or even abolished.

 

Prison overpopulation and the recidivism of short-term offenders are important issues, but should not be conflated.

 

The Times has published a graph of the prison population. As at April 2024, the number in England and Wales was about 88,000.

 

Although over half of people sent to prison each year are given sentences of less than a year, at any one time fewer than 4,000 are serving such a sentence.

 

The biggest single category of prisoner in the system is those serving over four years (but not indeterminate) – about 28,000.

 

It strikes me that in many cases sentencing an offender to, say, six rather than eight, or 12 rather than 15 years, would equally meet the prison objectives of punishment, rehabilitation and deterrence.

 

A statistician would need to work the figures through. But common sense suggests that such an approach would have a significant impact on the prison population – greater than restricting short-term sentences.

 

While politically no government wants to be seen as ‘soft on crime’, equally politicians are sensitive to offending and anti-social behaviour by regular nuisance offenders terrorising neighbourhoods. Law-abiding members of that community crave some respite from this. The backlash against the failure to prosecute shoplifters should be borne in mind here.

 

Andrew Bishop

Bishop and Light Solicitors, Hove; Law Society Council member for Sussex

 

Topics