The impact of the decline in the standard of maternity services

The Care Quality Commission (CQC) yesterday published its’ 2022 maternity survey. They surveyed 20,900 women and pregnant people who had a live birth in the month of February 2022. Concerningly, their headline finding is that “At a national level the 2022 maternity survey shows that people's experiences of care have deteriorated in the last five years.”

Whilst some elements of care,  such as mental health support being offered, are reported as having improved, there are a number of areas in which the experiences of parents-to-be are getting worse rather than better and, sadly, that chimes with what our clients are telling us.

Having acted in many maternity cases I am particularly worried to see that the elements of maternity care which are declining are those which have led to our clients’ babies suffering life-changing injuries or dying. Those elements include staff not being on hand when needed, parents not being involved in decisions made about their care and birth, including where to have their baby, and parents-to-be not being given the correct advice or support.

Staff not on hand when needed

The CQC survey found that only 57 per cent of women were always able to get help from staff when they needed it in hospital, and 10 per cent said they were not able to get help when they needed attention.

Many of our clients report not being able to get help when they were concerned about their baby’s wellbeing. They describe having to send partners or relatives out to search the hospital corridors for midwives or being told that the doctors were too busy with other patients to come to see them. Sadly, in the cases we deal with this has led to delays in picking up on warning signs of babies being in distress and in need of intervention and, in particular, earlier delivery, that could have avoided life-changing injuries.

Parents not involved in decision making

In the CQC survey 74 per cent of women and other pregnant people said that they were always involved in decisions about their care during labour and birth, but that means that 26 per cent, approximately a quarter of people, were not always involved.

The law on consent is clear and women and other pregnant people should be involved In all decisions about their and their baby’s care, but again the survey’s findings reflect the failures in care we sadly still see all too frequently.  Often, we are talking to parents who were not consulted about even basic decisions and were not told the pros and cons of the options available to them, such as the options for their baby’s delivery, when they should be.  These failures give rise to claims when we can prove that had our clients been properly advised and involved in the decision-making they would have made choices that could have avoided a devastating outcome.

In the survey a fifth of women said they were not offered any choices about where to have their baby, whether that be at home, a midwife-led unit, a midwife-led unit in a hospital setting or obstetric unit.  Yet, each of these options has advantages and disadvantages which it is important that families are made aware of so that they can make fully informed decisions.  Again, the failure to properly advise families can give rise to tragic outcomes. For example, I  have acted for parents who were not properly advised that there were no doctors on duty at a midwifery-led unit and that should things go wrong it would take longer to get help than if they were in the obstetric unit. Sadly, the delays in arranging transfer from the midwifery-led unit led to the death of their baby.

Parents not given the correct advice and support

Eighteen per cent of those surveyed by the CQC did not feel they were given appropriate advice or support. Sadly, many of our clients did not receive the correct advice, particularly during the ante-natal period. For example, we are acting for mothers who were not advised of the risk of their baby contracting the group B Strep infection  so that they could test for it and sadly their babies were serious injured as a result.

New parents become our clients when things have gone wrong during their ante-natal care, labour and/or delivery and they want to know that lessons will be learned from their experiences.  To read that the quality of maternity care is declining rather than improving, is upsetting for them but also worrying for all of us interested in safer maternity care at it means adverse outcomes like the ones our existing clients suffered are more likely in the future and many more families will suffer similar devastating consequences. 

There have been many reports on how maternity services can be improved in just the last few years and this survey emphasises the need to act on the recommendations in those reports to improve those aspects of maternity care that are declining rather than improving as we would all hope.