What About Mum?

A report on maternal healthcare by Royds Withy King

Pregnancy and childbirth is a special time for many. Not without its challenges, for sure, but something that mostly leads to a happy new stage in people’s lives, especially if giving birth for the first time.

However, as maternal injury solicitors we understand all too well that for some women this is just not the case. Their care in labour may have been substandard, they may not have had all the risks properly explained to them during pregnancy, or they might be struggling with ongoing mental health issues following a particularly traumatic birth.

We understand that often the need to ensure a baby is safely delivered, an entirely sensible priority, can lead to other issues during the birth of a child. However, as professionals who represent women that have experienced the very worst maternal injuries, we think it is about time we all asked “what about mum?”

In order to do this, we wanted to raise awareness of the challenges faced by mums by asking them about their experience of childbirth. We therefore reached out to 202 women aged 18-45 across England & Wales who have had children in the last five years to find out more about how they were looked after during pregnancy, childbirth and beyond.

The survey told us what we already knew: a majority of mums have a good experience of childbirth. However, a substantial minority do not get the support they need, particularly in relation to mental health.

COVID-19 is the elephant in the room here, so we made sure to split our responses to compare the last 18 months to the period before, so we can also see how things have changed for mums who have given birth more recently.

We asked five questions of these mums, the full breakdown of which can be found here, and we received some telling responses and statistics. These can be broken down into three main themes...

    1. Mothers felt inadequately prepared for childbirth and the risks involved

    Pregnant women stand in row holding their bumps

    2. Mental health care after birth is lacking

    Pregnant women stand in row holding their bumps

    3. Physical care has suffered due to COVID-19

    Pregnant women stand in row holding their bumps

    Issue 1:

    Are mums properly prepared for childbirth?

    Preparing mums for the experience of childbirth, so that they are fully informed as to the potential risks of their chosen birth plan is vital. This is not just to ensure that injury is avoided, though that is a crucial aspect of it, but so that mums can be mentally prepared for the damage that can be done to their bodies.

    The injuries that can occur and the risks of them happening are not widely talked about, even if they are not very serious, and this is something that is borne out when speaking to many mothers. This was particularly the case with our client Jo Flaherty, who experienced major injuries during childbirth as well as ongoing nerve damage to her spine and agreed to speak about her experience in order to help us raise awareness:

    I can genuinely say that in the majority of my appointments and discussions with health practitioners were all more to do with birthing plans etc. The only time that we did have a discussion about birthing risks was when they identified my son was a large baby, but outside of that I can say that I did not even have any knowledge as to how bad injuries could be, particularly in childbirth”.

    Jo’s comments appear to be borne out in the survey we conducted, where overall we found that nearly 36% of all respondents did not have all the risks explained to them in preparation for childbirth.

    As you may expect, this statistic was worse for mums who gave birth in the last 18 months, changing from 67% to 62% of mums saying they felt they had all the risks explained to them.

    Later in the survey, we also asked mums which areas of care they feel could improve. 41% stated that they wanted more information on birthing options, and nearly 35% said they wanted more of an explanation as to the risks to themselves.

    These results paint a stark picture, with around a third of mums consistently saying that the risks of childbirth were not properly explained to them in advance.

    Issue 2:

    Mums need more mental health support

    We welcomed the news that the Government is soon to open 26 new sites to help mums with post-natal physical and mental health care. If our survey is anything to go by, mental health support is something that mums feel is sorely lacking.

    When we asked what aspects of care could be improved, nearly a third of mums said that they felt mental health care during pregnancy could be made better and 27% said the same for post-natal mental health care.

    More concerning though was that just over 17% of mums we surveyed stated that they did not feel concerns about their mental health before and/or after the birth of their child were listened to. To us this is a shocking statistic, and one that should also concern the NHS as they develop the new sites to offer care to mums after birth.

    COVID also appears to have been a small factor in making mental healthcare worse for mums recently, the number saying they didn’t feel listened to about their mental health going from 16% to 19%. However, this appears to be an ingrained issue and so COVID has only had a small impact on it.

    These results did not surprise Jo, our client, when we raised them with her:

    Even though eventually I received the physical support that I required to repair my injury, there was never that opportunity to address what was a traumatic, shocking occasion in your life”.

    Even after her injury was repaired, Jo explained the mental impact that childbirth can have on mums:

    Everybody thinks you’re OK now; you just move on. I don’t think people understand what that’s left you with. If it wasn’t for my sisters and my mum, I think I would have been far less able to discuss it or even to admit there was an issue”.

    We should note; whilst we raise the issues mums have with mental health support, we recognise that no two women will have the same experience. Providing the right support is not easy, and means working with the individual and their family as one unit.

    Pressures after childbirth also don’t just affect mums, but can ripple out to the whole family unit. Those we have seen who are critical of the Government’s plans for 26 new maternal health units point out that more needs to be done to help dads and others in the surrounding family support network too. They feel that, unfortunately, much more will still need to be done even with this new investment in maternal healthcare.

    Issue 3:

    Physical care and aftercare have suffered due to COVID-19

    COVID-19, as stated above, is the elephant in the room. The NHS has done a fantastic job caring for people across the country and still managing to provide a place for mums to have a safe birthing experience – and this was reflected in our survey.

    However, of the mums we surveyed, those who gave birth in the last 18 months seem to feel more that their physical health was not a priority.

    Across the whole survey, 10% of mums said they did not feel concerns about their physical health were listened to or acted upon. When we look at mums from the last 18 months, this became 14%. 

    Whilst not a large proportion of the respondents, it is telling (though perhaps not surprising) that there has been this change.

    Conclusions

    The reactions from Jo, our client who experienced severe maternal injuries, speaks to the impact of these statistics.

    If someone who experienced a catastrophic injury because of negligence is identifying with what a significant minority are saying about being prepared for birth, how many mums are potentially being put at risk of life-changing injuries?

    Furthermore, if someone with Jo’s level of injury did not feel able to speak out about the damage done to her by childbirth, what about someone who has only experienced minor injuries or problems after giving birth but is still suffering nonetheless?

    It is vital that in pregnancy, during labour and beyond medical professionals listen to mums’ experiences and think “what about mum?”, whether they have experienced a significant injury or not.

    We welcome the news that the Government will be opening new dedicated centres for post-natal care, but what is vital to learn from our survey responses and Jo’s testimony is that mums need to actually be listened to by medical professionals. More resource delivers nothing if mums concerns are ignored or shut down by those who have a duty of care.

    This is especially important as we move forward in the uncertain times of COVID-19. Physical and mental care has been affected across the board, but for mums the changes seem to have particularly affected the way in which medical professionals respond to concerns about their physical health.

    We hope that this report helps to convey some of the messages that we know mums across the country want to share, but don’t feel they can. We want to give mums a voice and encourage everyone who can make a difference to the experience of maternity care to think “what about mum?”.

    Picture of Hannah Blackwell, Associate in Royds Withy King's Clinical Negligence team

    Hannah Blackwell, Head of Maternal Injury

    Hannah Blackwell, Head of Maternal Injury

    Picture of Rebecca Callard, Associate in Royds Withy King's Clinical Negligence team

    Rebecca Callard, Associate

    Rebecca Callard, Associate

    Picture of Faye Marks, Associate in Royds Withy King's Clinical Negligence team

    Faye Marks, Associate

    Faye Marks, Associate

    About the authors

    Our team of specialist maternal injury solicitors have a great deal of experience working with mums who have experienced injuries during childbirth and, being mums themselves, know the pressures that women can come under during maternity.

    They feel passionately about the rights of mums, having worked closely with many women who have experienced the very worst outcomes during pregnancy, childbirth and beyond.

    At Royds Withy King, we aim to build a Team Around the Client, and part of this is understanding the range of issues that face mothers around childbirth, not just their physical injuries. Therefore this 'What About Mum?' survey was an opportunity for us to advocate for mums as a community, and not just those who feel they might have a claim for negligence.

    Our maternal injury team, and whole Clinical Negligence practice, believe passionately in the rights of patients, and so we hope that this survey raises awareness and helps to change things for the better.


    If you have any questions about the study, or wish to contact a member of the team about it, please get in touch.

    For any media enquiries, please click here.