a The parliamentary inquiry into birth trauma in Britain received more than 1,300 written submissions. The stories shared were poignant. In many cases, the trauma women experience was caused by blunders before, during and after childbirth. Failures were often covered up by hospitals trying to frustrate attempts by families to find answers, a Guardian review of the evidence has found.
There were also many stories of a lack of compassion. Women were often ignored when they felt something was wrong, and were mocked, berated, or denied basic needs such as pain relief.
Women shared stories of being left in bloodstained sheets or calling for help and no one coming. Some reported being subjected to interventions they had not consented to. Many felt that they had not been given enough information to make decisions during birth. The poor quality of postnatal care was a recurring theme.
Some of the most devastating stories were from women who suffered birth injuries that left them with a lifetime of pain and bowel incontinence.
Women from marginalized groups, especially those from ethnic minority groups, appeared to experience particularly poor care, the study found. Some reported direct and indirect racism.
The most shocking stories to emerge during the three-month investigation focused on eight common themes.
Not listening
A woman who repeatedly reported to NHS staff that she was in extreme pain during the last few weeks of her pregnancy had a ‘worried mother’ noted on her notes. In fact, she was bleeding internally due to tissue tearing behind her uterus.
Another woman had to chase her hospital to schedule a scan, including 44 phone calls in one day, after her bump height dropped. Had she had a scan, as recommended in National Institute for Health and Care Excellence (Nice) guidelines, it would have shown that her baby had growth retardation. The baby died during childbirth.
One mother expressed concern that her baby looked yellow, but the midwife told her he was fine. “She wrote in my notes that I was an overly anxious mother and that my baby was not jaundiced.” Only after her husband intervened did a doctor confirm that their baby had jaundice. “The next day the page the midwife had written was torn out,” the mother told the inquest.
Lack of informed consent
Numerous women revealed that they had had procedures such as vaginal examinations or cervical examinations performed without consent. The study also found that there was a lack of consent for interventions using tweezers.
Several women reported that requests for caesarean sections were rejected. “I stated that I felt like my son was stuck and that I wouldn’t be able to get him out myself,” one woman recalled. “I had to wait forever for an epidural and begged for a c-section because I just knew something was wrong. She laughed at me and told me that doesn’t work like that.”
Bad communication
Many women described not disclosing what happened before, during or after childbirth, with some not finding out they had a specific medical condition until months later.
There were also communication errors. A woman whose baby died at five days received a call from a health visitor: ‘Congratulations on your baby! When can I come visit you?”
Another woman told the inquiry that after an ‘intense traumatic birth’ she was informed by a midwife that her blood tests indicated she had been drinking and taking drugs during pregnancy. As a result, her daughter was given an HIV test without her consent. In fact, the midwife had read from someone else’s notes.
Lack of pain relief
Many women reported a lack of pain relief, and some were left in agony. A woman who refused paracetamol because she felt it was insufficient said a midwife responded by throwing the medicine in the sink. “I literally lay on the floor in pain and wanted to die because the pain was so intense and unbearable,” she wrote.
Lack of kindness
The vast majority of written submissions complained about a fundamental lack of kindness or compassion on the part of the health workers who cared for them.
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“I was covered in blood and my own feces, but there was no one to help me wash,” one new mother wrote. “Around midnight I was woken up by a woman scolding me for not feeding my baby… I didn’t know how to breastfeed. She told me if I didn’t get it she would take my son and give him a bottle. I felt like I was failing at motherhood and that I had only been a mother for a few hours.”
Problems with breastfeeding
Many women cited breastfeeding difficulties as major factors contributing to their trauma. There were stories about being forced to breastfeed when it was impossible, or feeling like a failure because you couldn’t breastfeed.
Women were often pressured to breastfeed but were not helped to do so. “I had no idea how to breastfeed,” one new mom wrote. “Ringing the bell at night yielded no one and attempts to request midwives during the day were rejected.”
Postnatal care
Poor postnatal care was noted in almost all submissions. Some women described being left alone after birth and no one being able to help them in emergencies.
“Six hours after (my son) was born, I had a heavy hemorrhage,” one woman wrote. “I saw my white hospital sheets turning red and I thought I was bleeding again. I rang my bell, no one came. I pressed harder again and no one came.”
Another new mother across from her eventually had to leave her bed to get help. “At that moment I believed I was dying and that my baby would be alone in the hospital with his mother dying next to him and no one there to love him or even know his name. I was terrified,” the woman said.
Several people shared stories of having to lie in their own blood, urine or feces. Some said they were scolded by midwives for soiling themselves.
A woman who developed sepsis after an emergency caesarean section told how she was expected to change her own baby despite being on an antibiotic drip that limited her mobility. “The staff pushed her to the foot of the bed and told me to clean up the baby because she had been sick and was dirty, and walked away,” she told the inquiry. “I heard the staff sitting outside the bay at the nurses’ station laughing and planning to order a Chinese takeaway before they close.”
Poor postnatal care continued once the women were home. Mental health symptoms or complaints after a traumatic birth were often ignored or dismissed, the study found.
Complaints and medical negligence
Birth trauma was often made worse by hospitals failing to deal sensitively with complaints about poor care, women said. Complaints were often treated negatively, with shortcomings in care not being recognized. The investigation revealed that medical notes were lost or even falsified.
A woman who gave birth to a stillborn baby raised the alarm at 36 weeks that her baby’s movements had slowed, but was told by NHS staff at the time that this was “normal” for that stage of pregnancy. When she later reviewed her own medical notes, they incorrectly stated that it was she who had said her baby’s movements were “normal.”