Hungry mothers and dirty wards

Hungry mothers, dirty wards and poor care are ravaging England's maternity services, while staff are receiving death threats for their work on some units, according to a new report.

Baroness Amos, who is leading the review into maternity care, said what she had seen so far “was much worse” than she expected.

Some women felt guilty for the death of their child, while others suffered from a lack of sympathy, care or apology when things went wrong, and poor and black mothers were often on the receiving end of discriminatory services.

Health Minister Wes Streeting, who set up reviewstated that “the systemic failures that cause preventable tragedies cannot be ignored.”

Speaking on BBC R4's Today program on Tuesday, Baroness Amos said she was “confident… that change will happen” as a result of her review.

She said that while she did not have the powers conferred by a statutory public inquiry, she was keen to identify “systemic changes” that could improve the quality of care in hospital trusts across the country.

She said she had heard stories of women being “left in… rooms for hours”, adding: “women bleeding in bathrooms.”

But she stressed that she was studying the worst cases. “There's a lot of good care here” and many foundations are doing “good work,” she said.

Streeting said the news from Baroness Amos “demonstrates that too many families have been disappointed, with devastating consequences.”

“I know that NHS staff are dedicated professionals who want the best for mothers and babies and that the vast majority of births happen safely, but the systemic failures that cause preventable tragedies cannot be ignored,” he said.

The National Maternity and Newborn Inquiry aims to make a set of national recommendations to improve maternal and newborn services after previous inquiries identified problems but failed to produce sufficiently sustained improvements.

Baroness Amos' final report will be published in the spring, but the interim report – her reflections and initial impressions three months after the inquiry began – highlights how entrenched poor care is.

The former UN diplomat said she acknowledged there was “skepticism” and “criticism” about her approach.

“Time and time again, families feel that the system has failed them. I really hope that doesn't happen this time. And I think the fact that the Secretary of State has taken such a keen interest will make a big difference.”

Several inquiries over the last decade, including investigations into maternity services in Morecambe Bay, Shrewsbury and Telford and East Kent, resulted in 748 recommendations for improvement, according to the Amos review.

And yet the harm continues – the biggest request for pregnancy and childbirth in the history of the NHS, which dealt with around 2,500 cases in Nottingham, is due to report in June, and one more request It was recently announced that he is under the care of Leeds Teaching Hospitals NHS Foundation Trust.

After visiting seven NHS trusts and meeting more than 170 families, Baroness Amos said she was continually faced with:

• lack of cleanliness, women not receiving food or assistance to toilet, and catheters not being emptied.
• women are not listened to, including concerns about decreased fetal movements
• women of color, working class women and people with mental health problems receiving discriminatory care
• NHS organizations “marked homework” when babies died or were injured and bad behavior, including bad language, was not addressed.

The review also involved maternity service staff. Some reported having rotten fruit thrown at them, while others said they had received death threats following negative publicity or were attacked on social media.

Negative media attention can make it difficult to provide high-quality care, they said, although it has also acted as a catalyst for improvement.

Baroness Amos' investigation is controversial. Some families feel that the limitations on what they can do and the short time available to do so mean that meaningful action cannot follow.

Emily Barley of the Maternity Safety Alliance, which wants a statutory public inquiry into maternity failures, said initial considerations had “prioritised” the feelings of staff while minimizing the “preventable harm that happens every day in NHS maternity hospitals”.

“This is a completely flawed process to correct deep-rooted and long-standing shortcomings in maternity care, and we don’t understand why [Wes Streeting] allows this farce to continue.”

Tom Hender, whose son Aubrey was stillborn in 2022, said a full public inquiry was the “only credible option”.

“The audit has already revealed more than the chairman expected,” he said. “This should be the clearest sign yet that the scale is not appropriate and that the problems are larger than the time frame can resolve.”

In the new year, Streeting will lead the new National Maternity and Neonatology Working Group, which will be responsible for implementing Baroness Amos' recommendations. He promised that families affected by poor care would “remain at the heart” of what follows the review.

James Titcombe, a long-time maternity care campaigner since he lost his son Joshua in 2008, said that while the problems identified by Baroness Amos “reflect long-standing problems that we have known about for many years”, he backed her work as representing “the best opportunity in a generation to finally put maternity services on a safer path”.

Rhiannon Davies, who lost her daughter Kate in 2009 and was instrumental in setting up the inquiry into Shrewsbury and Telford Hospital NHS Trust, said she believed Baroness Amos was “listening and we need to make sure her work leads to real, urgent change when she publishes her findings next year”.

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