Hundreds of stillbirths have been have been linked to inadequate care in new data that lays bare the scale of maternity failings across the NHS in England.
The number of clinical claims made against the NHS for stillbirths rose from 129 cases in 2019/20 to 200 cases in 2023/2024 – a 55 per cent increase – data obtained through Freedom of Information (FOI) requests shows.
During this period, a total of 750 claims were made by people who had suffered stillbirths, with the NHS paying damages in 473 cases. In the previous five-year period to 2018/19 some 646 stillbirth claims were made against the NHS, with damages paid in 399 cases.
Between 2019 and 2024, some 737 stillbirths were investigated by the Maternity and Newborn Safety Investigations Programme (MNSI), with almost two-thirds of those reports – equating to 485 stillbirths – leading to safety recommendations being made to healthcare providers, according to the FOI data obtained by law firm Forbes Solicitors.
The MSNI is part of a national strategy to improve maternity safety across the NHS in England, with all NHS Trusts required to report certain maternity safety incidents to the MNSI, so that independent investigations can be carried out.
NHS officials said the stillbirths reported to MNSI is only a small proportion and likely to be ones where there are concerns about care.
But Leonie Millard, a partner specialising in clinical negligence at Forbes Solicitors, said: “The biggest concern is that maternity care doesn’t seem to be improving.
“During the past three years, there’s been very little change in how many MSNI reports have led to safety recommendations being made to healthcare providers. This raises questions about whether learnings are being taken on board and shared to address issues and enhance maternity care standards.”
James Titcombe, chief executive of Patient Safety Watch, said that while MSNI’s investigations highlight issues in individual cases, there is a risk that broader systemic issues are being overlooked.
“MNSI’s work is valuable, and many of their recommendations rightly respond to specific safety concerns,” Titcombe told The i Paper. “But across multiple investigations, we’re seeing common themes emerging again and again. There’s a real need for MNSI to go further – by making recommendations that address weaknesses in the maternity system as a whole, not just at the level of individual trusts.”
According to Millard, it now takes almost 26 weeks for the MSNI to complete an investigation, suggesting more time is required to unravel maternity care problems.
MBRRACE-UK, a national program in the UK responsible for monitoring and investigating the causes of maternal and infant deaths has been collecting data since 2013, when the stillbirth rate in England was 4.27 per 1,000 births. It declined to 3.33/1000 births in 2019 and was at 3.27/1000 in 2023 – according to its latest State of the Nation report.
Of the 565,547 births in England in 2023, some 1,847 were stillbirths while 914 were neonatal deaths. This is down from 2,832 stillbirths and 1,215 neonatal deaths out of a total 665,018 births in England in 2013.
Titcombe said this reduction was encouraging but well below the Government’s target for a 50 per cent reduction by 2025.
“What’s more worrying is the lack of progress in other key areas – maternal deaths have risen by 42 per cent since 2018 and the rate of babies born with brain damage has barely changed, from 4.25 per 1,000 live births in 2012 to 4.18 in 2021. That lack of system-level improvement is a major concern,” he said.
‘I woke up to be told my daughter had died’
Amie enjoyed a “really beautiful pregnancy” with her baby Ava but was “really let down” during labour.
Amie had opted for sweeps, a procedure that can help to start labour, at just after 39 weeks and was sent to hospital for an examination and scan. Her waters had not broken and a sonographer reported Ava had had a growth spurt. She was now around 8lbs 1oz, quite an increase on the previous week’s scan – which had given her an estimated weight of 7lbs 4oz.
“That put me in a little bit of a panic,” Amie said. “I went home and started labour at about 3am on the Monday, which was a shock but we were due to be induced on the Wednesday – 41 weeks on the dot.”
Amie kept in touch with her local hospital as her contractions progressed but said staff “changed the goalposts”, giving her different information regarding the frequency and length of contractions before she should come in to give birth.
Over the next 48 hours, she was told to “go and have a bath” and take some paracetamol. “I must have been in and out of that bath every two hours,” Amie said.
Amie said she was speaking out in the hope lessons would be learned from her tragic experience.Two days later, after the pain between contractions became severe, Amie and her husband Andrew took themselves to hospital. She was classed as “high risk” due to previous pregnancy complications, including an ectopic pregnancy, but said a midwife compared her to “paranoid, first time mums”.
Amie was eventually booked in for an induction the following morning and sent home without pain relief. A few hours later, she noticed some spotting – fresh blood – and returned to hospital, but it was too late.
Amie had suffered a placental abruption, where the placenta separates from the inner wall of the uterus before birth. It can deprive the baby of oxygen and nutrients and cause heavy bleeding in the mother.
Amie was able to hear her daughter Ava’s heartbeat before she was taken into surgery for an emergency C-section.
“By the time my husband arrived [after parking the car] I was being wheeled down… I thought it was the last time I was going to see him, and I was quite prepared for that as long as they got my baby out.”
Amie woke up in recovery and was told her daughter had not survived. She was allowed to hold Ava for a few minutes. Andrew was in a different room and staff did not allow him to see his daughter or his wife until Amie had woken up. “That must have been excruciating for him… It’s absolutely diabolical really.”
A Healthcare Safety Investigation Branch (HSIB) report into Amie’s care found a litany of errors including a lack of communication between NHS staff and failure to escalate her case quickly enough.
Amie said she was speaking out in the hope of helping others and that lessons can be learned from the tragedy. “I do hope things will change. How much, I don’t know… It’s happening all too often, to too many people all over the country. It needs to change.”
Separate research by the House of Commons Library, commissioned by the Liberal Democrats, has revealed that the number of direct and indirect maternity deaths has risen by more than a fifth to 254 between 2021 and 2023, up from 209 in 2015-17. The 22 per cent rise means that the death rate per 100,000 maternities now stands at 12.67 – far higher than in 2015-17 when it stood at 9.16.
Lib Dem Primary Care and Hospitals spokesperson Jess Brown-Fuller said: “It is appalling that maternity deaths are rising even after the years of concern over the state of services that has led to so many scandals with deadly consequences.”
Meanwhile, analysis of NHS figures shows the potential bill for maternity negligence in England since 2019 has reached £27.4bn – far more than the health service’s roughly £18bn budget for newborns in that time.
The number of families taking legal action against the NHS for obstetrics errors rose to a record of nearly 1,400 a year in 2023, double the number in 2007, according to FOI figures obtained by The Guardian. About half of the 1,400 claims a year may not result in compensation payouts, so the amount paid out would be lower. However, compensation only accounts for part of the total £27bn figure, a larger share being legal costs
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Labour MP Paulette Hamilton, the acting chair of the Commons health and social care select committee, said the figures were “absolutely shocking” and represented a “devastatingly high number of deaths and injuries of mothers and babies”.
NHS Resolution, the organisation that handles negligence claims for the NHS trusts in England, recorded in its most recent annual report last week that the cost of settling all maternity-related claims was £37.5bn. The figure, relating to claims which may have been made up to several years ago, amounts to nearly two-thirds of its total £60bn clinical negligence liabilities bill, a sum described by senior MPs as “jaw-dropping”.
An NHS England spokesperson said that too many women and families are not receiving the high-quality maternity care they deserve.
“We are committed to changing this,” they added. “We are taking immediate steps to strengthen maternity services, including closer oversight of underperforming trusts, and will work with the independent investigation to ensure we learn from its findings and deliver the comprehensive changes that women and families need and deserve.”
‘Rapid’ national inquiry launched
So many babies and women have died or suffered life-altering conditions as a result of botched care in NHS trusts across the country in recent years, that the Government has launched a “rapid” national inquiry.
Speaking at the Royal College of Obstetricians and Gynaecologists’ (RCOG) annual conference in June, Health Secretary Wes Streeting said the inquiry would urgently look at the 10 worst-performing services in the country, as well as the entire maternity system.
Streeting did not say how much the investigation would cost but that he expected it would be “somewhat less” than the “enormous” amount paid out by the NHS in clinical negligence claims.
Millard said: “We often find parents aren’t aware of maternity healthcare issues until they’ve been told that an investigation is being carried out. In many cases, parents will be suffering immense grief, and although they may have an inkling that something went wrong during their care, it’s difficult to process this until they see it validated in a report.
“Sadly, the length of time spent carrying out stillbirth investigations can prolong the suffering of parents and leave them fatigued. Supporting parents to take action can help hold failings to account to drive improvements in maternity care standards.”
The Department of Health and Social Care has been approached for comment.
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