Why Better Maternity Care And Support Matters

For expectant parents, feeling heard, informed and supported throughout pregnancy and birth is vital. A consistent theme has been poor communication; people feel their concerns have been dismissed, that they have not been given the support they require, and they have not been given information in an appropriate way.

The publication of Donna Ockenden’s final report into maternity services at Nottingham University Hospitals NHS Trust highlighted concerns about communication, patient safety and accountability within maternity services. These concerns are not unique to Nottingham but reflect issues identified repeatedly across maternity services nationwide.

Poor communication is often a contributory factor as to why people pursue a clinical negligence claim. Being pregnant and giving birth is a challenging experience, especially so when there are medical concerns for the parent or child. Difficult decisions need to be made and complications can occur. If parents do not feel as though they are fully informed during the pregnancy or birthing process, and there are complications, they are often left with unanswered questions. Why did things go wrong? Would things be different if we had pushed for a particular treatment? If these questions are not fully addressed, people will often consider pursuing a claim to get much needed answers.

Maternity claims made up 57% of the total estimated new claims (by value) reported to NHS Resolution (the Insurer for NHS Hospital Trusts) in 2023/2024 and £1.3 billion of the total clinical negligence payments in 2024/25 were related to maternity.

Not all complications during birth will meet the required legal standard for a clinical negligence claim, sometimes injuries can occur without it being anyone’s fault or due to any negligent treatment. However, the impact of poor communication during pregnancy and birth can have long-term effects.

A report on the cost of perinatal mental health problems from 2014 confirmed that, ‘Perinatal mental health problems are very common, affecting up to 20% of women at some point during the perinatal period. They are also of major importance as a public health issue, not just because of their adverse impact on the mother but also because they have been shown to compromise the healthy emotional, cognitive and even physical development of the child, with serious long-term consequences’.

The first three key findings of the report are:

• Taken together, perinatal depression, anxiety and psychosis carry a total long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK. This is equivalent to a cost of just under £10,000 for every single birth in the country.
• Nearly three-quarters (72%) of this cost relates to adverse impacts on the child rather than the mother.
• Over a fifth of total costs (£1.7 billion) are borne by the public sector, with the bulk of these falling on the NHS and social services (£1.2 billion).

The report found that to bring perinatal mental health care up to the standards recommended in national guidance, it would cost £280 million.

Aside from the staggering cost of poor maternity care, the effects on the family are devastating and life-changing for everyone involved.

There are a number of stressors on the NHS (including staffing, financing, administration and the changing and increasing medical complexities of patients) which impact on the medical care and treatment that can be provided. A lot of work has, and is, being done to try and counteract these factors and to improve standards generally. NHS Resolution has a Maternity Incentive Scheme designed to financially reward Trusts that are meeting certain standards.

Recently, the National Maternity and Neonatal Collective met with the Secretary of State for Health (James Murray MP), Baroness Gillian Merron, Michelle Welsh (MP and National Maternity Advisor) and Donald Peebles (the National Clinical Director for Maternity at NHS England) to discuss maternity and neonatal care generally, including perinatal mental health care.

Heidi Eldridge, Founder and CEO of MAMA Academy, attended the National Maternity and Neonatal Collective meeting and when asked to comment said:

“This speaks to something we hear from bereaved and traumatised families time and time again: it is so often not just what happened, but the silence afterwards, that causes the deepest harm. As part of the National Maternity and Neonatal Collective, we are calling for a truly independent mechanism for investigating maternity safety failures, so that parents get the answers they deserve and the same mistakes are never repeated. Communication and accountability are not optional extras in maternity care; they are fundamental to safety. We are grateful that the Secretary of State took the time to listen to our concerns, and we will keep pushing until every family gets the honest, timely answers they are entitled to.”

Speak With Us Confidentially

The issues highlighted here show how important communication is during perinatal care.