One in five women feel their concerns were ignored during critical moments of childbirth. This alarming finding comes from a national survey of nearly 17,000 women who gave birth in NHS maternity services in England this summer, revealing serious deficiencies in the care system.
According to the survey conducted by the Care Quality Commission (CQC), in addition to the concerns of 18% of women being ignored, 15% did not receive adequate guidance or support when contacting a midwife at the start of their labour. Furthermore, one in ten women reported being left alone at a critical point during their maternity care when they were worried, with 7% experiencing this during the “final stages of labour,” the most perilous moments.
🔍 The Depth of the Crisis: From Physical Harm to Systemic Inequality
Statistics and reports indicate that these negative experiences are not merely feelings of discomfort but have tangible, sometimes disastrous, consequences.
- Increasing Physical Injuries: New NHS data shows that the risk of severe injuries during childbirth is rising. The rate of third and fourth-degree perineal tears (anal sphincter injuries) has increased from 25 per 1,000 births in 2020 to 29 per 1,000 births by June 2025, representing a 16% rise. These injuries can lead to incontinence, chronic pain, sexual dysfunction, and psychological issues such as PTSD.
- Structural Discrimination Against Black and Ethnic Minority Women: The crisis is not equal for all women. Official data reveals that Black women are more than twice as likely to die during pregnancy or within six weeks after childbirth compared to white women. For Asian women, this figure is 1.3 times higher. A separate survey of Black women also showed that nearly half of those who expressed concerns during labour felt these concerns were not properly addressed. A parliamentary committee has attributed this situation to “systemic failures in accountability and leadership” and “bias, stereotyping, and racist assumptions.”
- Poor Service Ratings: The latest CQC national assessments show that of the 15 maternity services inspected under a new evaluation framework, approximately two-thirds (66.7%) were rated as “Requires Improvement” or “Inadequate.” Meanwhile, reviews of baby deaths found that in 30% of these cases, there was at least one issue with care that may have affected the outcome.
⚙️ The Roots of the Crisis: Staff Shortages and Overwhelming Workload
Experts and officials point to a chronic shortage of human resources as the core of these problems.
- Midwife Shortage: The Royal College of Midwives (RCM) estimates a national shortage of approximately 2,500 midwives.
- Unmanageable Workload: The 2024 NHS staff survey revealed that only 16% of midwives believe there are enough staff in their organization to do their jobs properly. This figure is 34% for all staff.
- Workforce Burnout: 57% of midwives reported that their work emotionally exhausts them (compared to a 34% average across all staff).
Gill Walton, Chief Executive of the Royal College of Midwives, says: “These findings highlight the immense pressure midwives are under due to chronic staff shortages. When midwives are overstretched, it is much harder to provide the careful care that allows them to truly listen and respond to concerns.”
🛡️ Responses and Ongoing Measures

In response to this complex crisis, multiple actions have been initiated at various levels:
| Action | Explanation and Goal |
|---|---|
| National Birth and Babies Inquiry | A rapid national inquiry has been launched by the new Health Secretary to hear from families and review practices. |
| National Maternity Improvement Strategy | The report by the parliamentary “Birth Trauma” group has called on the government to introduce a National Maternity Improvement Strategy. |
| Increased Training and Recruitment | The NHS Long Term Workforce Plan aims for a significant increase in domestic training, targeting approximately 58,000 training places for midwifery and nursing by 2031. |
| Efforts to Improve Learning Culture | Emphasis has been placed on better incident reporting and systematic learning from events to prevent the cycle of failure from repeating. |
💡 Future Outlook: A Long Road Ahead
Although the CQC survey indicates minor improvements in some areas, such as increased access to mental health support during pregnancy (to 89%), warning voices suggest that key problems have not improved since last year.
Valerie Amos, overseeing a national inquiry into maternity care, has described this situation as “unacceptable”. It appears that England’s health system faces a long and challenging journey to restore lost trust and ensure safety and dignity for all women during one of the most vulnerable moments of their lives. Success on this path depends on the rapid, transparent, and adequately funded implementation of reform plans, coupled with genuine systemic accountability to affected families.
Guardian



