If you think you may have experienced clinical negligence at any point during your pregnancy, birth or post-natal care and this has had a long term effect on any aspect of your health, please see our medical negligence page for more information on how to get in touch.
Maternity care guidelines in the UK tend to be robust. Organisations such as the CQC inspect services to ensure quality care and there are extensive guidelines from NICE and the National Service Framework for Children, Young People and Maternity Services which provide guidance on how pregnancy and birth should be handled by medical professionals. There are an estimated 700,000 live births in the UK each year and in 2014, the NHS paid £410m in obstetrics claims, which was 41% of a £1.1bn compensation budget.
Your first point of contact during pregnancy is likely to be your midwife. In current maternity policy, there is a strong focus on the role of the midwife and the continuity of care you should receive. In the 2015 CQC maternity survey, 37% of women saw a midwife as their first point of contact. The NHS actually has a named midwife policy which states that “every woman has a named midwife who is responsible for ensuring she has personalised, one-to-one care throughout pregnancy, childbirth and during the postnatal period, including additional support for those who have a maternal health concern” (Department of Health: Crown Copyright, 2012).
In 2015, the CQC maternity survey found that 62% of women are not seeing the same midwife for their antenatal appointments. 28% of these women wanted to see the same midwife and were not able to.
15% of women surveyed also said that the midwives were not always aware of their medical history.
Why is this important? Pregnancy is essentially a 9 month medical condition that requires careful monitoring and care. Recommendations are in place for you to have consistent care, as this allows healthcare professionals to pick up on any potential changes to your health or flag any possible problems. Receiving consistent care would go a long way to preventing many medical negligence cases. If you want to see the same midwife, and it is not an emergency, you should be able to.
The CQC survey also found that although 98% of women said they had a telephone number for a midwife or midwifery team that they could contact, 26% of women were not always able to get the help they wanted, with 20% only receiving help sometimes and 6% reporting that they were unable to get the help they needed. NICE guidelines state that women should be given information on how to contact their midwife and what to do in an emergency.
The birth of your baby is often well-planned and a beautiful moment. Your birth plan may include details of your chosen pain management, where and how you choose to give birth, who is present and a lot of other factors. A written birth plan helps your medical team to know exactly what your preferences are for treatment, even at difficult moments during labour. You can build a birth plan online using the NHS website.
Pregnant women have the same rights as everyone else when it comes to making decisions about their body. It is against the law to give you medical treatments that you have not consented to, unless you are unable to make a decision because you lack the capacity or your condition prevents you from doing so (e.g. if you are unconscious). Any medical treatment given to you without your consent is not only classed as medical negligence, it also constitutes battery.
You must also give genuine consent. If you feel you have been coerced or bullied into giving consent to a medical procedure, the consent is not valid. There must always be an individual discussion between you and your doctor, nurse or midwife. Your healthcare professional must always explain the risks to you of any procedure, and can recommend a particular medical option to you. They cannot, however, unduly influence you by threatening to withdraw care if you refuse consent, impose any arbitrary time limits on decision making, threaten to refer you to social services, repeatedly or aggressively state risks or put pressure on your family members. Your birth partner or companions can be your greatest advocates, if they are familiar with your birth plan and aware of your rights as a patient.
The CQC Maternity survey found that a quarter of women (25%) felt they were not always involved in decisions about their care during labour and birth. By law, your wishes must be respected and your consent to medical procedures is mandatory.
With such an intense focus on pregnancy and birth, post-natal care may not have been a huge consideration for new parents. A healthy, happy baby is the goal of your pregnancy and once delivered, a child will become your number one priority. But in the immediate hours, days and weeks after giving birth, you become more at risk of some serious illnesses, making your post-natal care more important than you might think.
Your body’s ability to heal from pregnancy and birth is greatly impacted by your care and environment. Experiencing medical negligence during this time can make it more difficult for you to care for your child, delay your ability to return to work or impact on your enjoyment of life. It can even lead to anxieties about pregnancy and childbirth, affecting your future family planning decisions or your mental health.
Mumsnet have recognised this potential gap in the quality of our maternity services with their “aftercare, not afterthought” campaign. Their recent survey had some startling results about the state of post-natal care for mums in the UK.
Of the women surveyed by mumsnet, 45% were sometimes unable or not able at all to access pain relief when they needed it. When you have given birth, you are beginning a slow road to recovery as your body has been through a major trauma. If you are denied a treatment option, such as pain relief, it should always be explained to you why you are unable to receive it.
Even more distressingly, the survey found that 61% had been unable to access food when they needed it and 21% had been unable to access water. These are basic human requirements. For the sake of you and your baby, you should always have access to food and water. Malnourishment or dehydration can significantly affect your health and the post birth healing process.
19% of those surveyed had been unable to access washing facilities when they needed them. For the prevention of infections or viruses, cleanliness is important. The government guidelines on post-natal care for mothers are surprisingly limited. With some guidance on mental health and a mention of complaints about poor standards for hygiene in the hospitals, there is little in the way of guidance in ‘Maternity Matters’ on your rights to access washing facilities. The CQC lists clean and suitable premises and equipment as one of their fundamental standards of care.
Pregnancy and mental health has been high on the agenda for some years, with more focus than ever into providing mums with the care they need to deal with ante-natal mental health issues or post-natal depression. Clinical negligence during post-natal care can contribute to serious mental health conditions such as PTSD or post-natal depression.
The mumsnet survey also found that, of the 1200 people new mums surveyed, 19% of women who had a hospital stay say it negatively affected their mental health, with 5% attributing the hospital environment as a contributing factor to their post-natal depression.
14% said their experience on the postnatal ward had 'made them think twice' about having more children and 5% said it had 'contributed to a decision not to have any more children. While midwives and doctors may be working harder than ever to identify and support people with mental health issues during pregnancy, birth and post-natal; the hospital environment itself and your treatment can elevate the risk of developing these conditions.
Our job as medical negligence solicitors is not to alarm newly pregnant women, but to help you to understand your rights and the responsibilities of your healthcare providers, particularly if this is your first baby. Knowing what should happen helps you to ask the right questions or challenge poor care before a case of medical negligence actually happens.
It is not always obvious that you have suffered medically negligent treatment during pregnancy. If you feel that you may have experienced clinical negligence during any point during your pregnancy; you have three years from the date you realised your treatment was negligent to pursue a claim. If you do want to get in touch for a chat, our calls are confidential and free.
If you would like to download our Pregnancy in the UK – The Numbers Infographic to share, please do so by clicking the link here.