The recent reviews of maternity care in the NHS have highlighted the pressing issue of maternal injuries which occur during childbirth, where mothers have experienced significant, and often, avoidable injuries
The final report of the independent Ockenden Review into maternity services at Nottingham University Hospitals (NUH) NHS Trust was published in June 2026. The report examined over 2,500 cases, revealing that more than 500 mothers and babies died or suffered avoidable harm. The report highlighted repeated failures by the Trust to listen to women, to respond to their concerns and recognised that there was a lack of support and communication to mothers in the maternity setting.
A further review into maternity services nationally by Baroness Valerie Amos was also published in June 2026. The investigations follow numerous high-profile failings at several NHS trusts, and the report notes that the maternity and neonatal services reviewed are ‘no longer fit for purpose’. The report found that women are not being listened to, it comments on the impact of staff shortages and capacity pressures and unfair treatment and structural racism in maternity settings.
However, the Amos report has faced criticism. The Birth Trauma Association have highlighted that the report omits discussion of severe third- or fourth-degree perineal tears or the use of forceps. There is also concern that the report lacks focus on the psychological injuries associated with a traumatic birth. These are complications and injuries which, sadly, we see all too often.
What is considered maternity negligence?
Expectant mothers place a great deal of trust in medical professionals to ensure they have a healthy and safe pregnancy and delivery. Maternity negligence occurs where the standard of medical care during pregnancy, labour or the post-partum period falls below a minimum standard of competence, often causing devastating consequences.
We have assisted many women with a wide range of birth related injuries to include perineal tears, uterine ruptures, post-partum haemorrhages, fistulas usually caused by prolonged labour, incorrect repair or stitching in an episiotomy or caesarean section, failure to manage pre-eclampsia or other infections as well as pelvic organ prolapse.
Perineal tears are one of the most common types of maternal injury we assist with. Sadly, the number of women sustaining third- or fourth-degree tears during delivery is increasing. NHS figures reveal that this number has risen from 25 In 1000 in June 2020 to 29 in 1000 in June 2026 – a 16% increase.
This is an injury which affects the soft tissue and skin between the vagina and anus, known as the perineum. There are four degrees of tear ranging from superficial to deep tissue involvement. Third- and fourth-degree tears are the most severe and are known as Obstetric Anal Sphincter Injuries (OASIS)
Why do perineal tears occur?
The vast majority of women who have a vaginal birth, particularly first-time mums, will experience some sort of tearing or episiotomy during childbirth, so tears during delivery are common. Tears, bleeding and bruising therefore may be a normal part of giving birth and would not be associated with negligent care. Often there are natural complications during delivery or there could be a complex labour which, ultimately, causes an injury to the mother. Therefore, a question that is often raised is how these injuries occur negligently, as opposed to being a normal consequence of a vaginal delivery.
In cases of negligence, the tear may be more extensive or may have been avoided entirely due to poor care or inappropriate techniques. There may be a delay with delivery, inappropriate instrumental delivery, misuse of forceps, or there may have been a delay or failure to consider that a caesarean section would be the best course of action.
It may be that the tear was not caused negligently, but it was not repaired correctly. Sadly, we have also heard from many mothers who were not told that they had sustained a tear and the injury was not properly diagnosed and treated until months, or in some cases, years later.
Many mothers report that they were not listened to and that communication was poor, similar failings were also identified in the recent reviews. These factors can cause delays or incorrect management of the delivery and may lead to negligently caused injuries.
We have helped many women who have experienced severe tearing which can result in urinary and bowel incontinence, the failure to manage gas and faeces, urgency or leakage, pain and discomfort during intercourse and generally in daily life, and, in some cases, the need for a stoma.
A mother may require a stoma to be fitted, either temporarily or permanently, to facilitate bowel function following a tear injury. Coming to terms with a stoma or incontinence can cause significant physical and emotional difficulties.
Emotional impact of a birth injury
Experiencing these injuries can often be incredibly traumatic and isolating. Many of our clients have suffered emotionally, experiencing PTSD and depression due to their traumatic injuries. These injuries can affect a mother’s ability to return to work, look after their baby and themselves, limit their social life and impact massively on their confidence and independence. They can also have a profound effect on relationships.
The consequence of these injuries can be long lasting and life changing. A mother is often at her most vulnerable after giving birth in any event. To then have to manage and navigate such debilitating injuries, in addition to the stresses and concerns that come with looking after a new baby, can, understandably, be overwhelming.
Many of our clients have benefited from the help and guidance provided by the MASIC Foundation. MASIC is a charity which supports women who have suffered Obstetric Anal Sphincter Injuries following childbirth. They are committed to ensuring better care, detection and prevention of these traumatic injuries. We are incredibly proud to be a legal partner of MASIC, and we have seen first-hand the difference that their support has made to so many lives.
Chloe Oliver, the CEO of the MASIC Foundation has provided her views in relation to the recently published maternity reviews and has also highlighted that the Amos report, disappointingly, makes no mention of perineal tears, being one of the most common injuries we assist with. We are in full support of the aims and goals of the Charity.
Chloe says:
“We welcomed the Amos Review with hope, believing it would build on the momentum created by the Ockenden report and deliver the urgent changes our maternity system so desperately needs. We are therefore profoundly disappointed that there is no mention of Obstetric Anal Sphincter Injury (OASI), the impact of forceps births, or the psychological consequences of traumatic birth.
Just this week, new data revealed that around 2,000 women sustained a third- or fourth-degree tear in NHS hospitals in the first three months of this year alone. Women who shared their experiences with the review deserved to see those experiences reflected in its recommendations.
While we welcome the proposal for a Maternity Commissioner and the review’s commitment to improving maternity care, there is still much work to do. As part of the NMNI Taskforce, MASIC will continue to ensure that women affected by birth injuries are heard and that their experiences drive the meaningful, lasting change maternity services urgently need.”
If you believe you may have a negligence claim in relation to treatment you received during labour or delivery, then please contact a member of our medical negligence specialist team today.
