Birth Trauma

Abena Oppong-Asare Excerpts

Thursday 19th October 2023 Commons Chamber

[Abena Oppong-Asare (Erith and Thamesmead) (Lab)]

I thank the hon. Member for Stafford (Theo Clarke) for securing this important debate. I know that she has worked hard to raise this issue both in the Chamber and through her work outside it. I want to express my deep admiration of her for sharing in public such a moving story about a terrifying experience. That takes a lot of courage.

I thank my hon. Friend the Member for Canterbury (Rosie Duffield) for her kindness and congratulate her on her work on the newly launched all-party parliamentary group for birth trauma. I know that it will be successful and productive. I thank the hon. Member for Moray (Douglas Ross) for sharing his personal story and being an ally. He rightly said that it is shameful that this is happening in 2023, and that is linked to what my hon. Friend the Member for Canterbury said about how her friends and family have to name-drop her before they can get the support that they deserve. I thank the hon. Members for North Shropshire (Helen Morgan) and for Truro and Falmouth (Cherilyn Mackrory), too, for sharing their stories. I also thank the mothers with experience of this issue who are watching in the Chamber, and organisations that are working really hard on the issue.

This has been a very constructive debate. As we have heard, birth trauma is a difficult experience for anyone, but it has been in the shadows for far too long. It is right that we are speaking about it today and making it clear to the Government and all Members of the House that there is progress to be made. Pregnancy, birth and becoming a parent can be a special and rewarding time for many people. It is the start of an exciting journey into parenthood and a time to celebrate new life. However, it is clear that, at a moment of such importance and sensitivity, when complications occur the right support does not always follow. The statistics on maternity outcomes lay bare the problem that we face. The level of support is down, satisfaction is down, and confidence and trust in the system is down.

The Care Quality Commission’s “Maternity survey 2022” reported that women’s experiences of care had deteriorated in the last five years. The proportion of women contacting a midwifery team who were given the help that they needed during antenatal care dropped from 74% in 2017 to 69% in 2022. As for postnatal care, only 70% of mothers were “always” given the help that they needed when contacting a midwifery or health visiting team, a fall of nearly 10% since 2019. The downward trends continue: less than half—just 45%—said that they could “always” get support or advice about feeding their babies during evenings, nights or weekends, down from 56% in 2017, and just 59% said they were always given the information and explanations that they needed during their care in hospital, down from 66% in 2017.

What those statistics show is that mothers do not have full confidence in our system, and things are only getting worse. It is therefore not surprising to hear that, according to the Birth Trauma Association, between about 4% and 5% of women who give birth develop a post-traumatic stress disorder: that is about 30,000 women a year in the UK. The symptoms include flashbacks, nightmares, and extreme anxiety that make daily life immensely challenging. This is a shocking and sad indictment of the current system and shows how much more needs to be done.

We should also not forget the vast health inequalities that exist across Britain. We should all be aware of the fact that women in the nation’s most deprived areas are 3.5 times more likely to die from an avoidable cause than those in the least deprived areas, and the fact—mentioned by my hon. Friend the Member for Canterbury —that maternal mortality among black women is currently almost four times higher than it is among white women. That is why Labour’s mission sets an explicit target to end the black maternal mortality gap. The pandemic, of course, exacerbated those existing inequalities, particularly among the most vulnerable women in our society. As we heard from the hon. Member for Stafford and my hon. Friend the Member for Canterbury, the feelings of anxiety, helplessness, and fear that those with birth trauma endure are traumatic for all, but for women also to know that they are more at risk because of their race, their income or where they live is shocking, sad and wrong.

Yesterday, along with the shadow Secretary of State for Health and Social Care, my hon. Friend the Member for Ilford North (Wes Streeting), I met representatives of the Maternal Mental Health Alliance. They welcome the roll-out of maternal mental health services in some parts of the country, focusing on those with mental health difficulties arising from trauma or loss related to childbirth, fear of childbirth, miscarriage, stillbirth, neonatal death, pregnancy termination and loss of custody whose needs are not currently met by other services. What concerns them is that these services are not available in every part of England. As the hon. Member for Stafford pointed out, there is significant variation in the support offered by the services that been rolled out so far, creating a postcode lottery for women, babies and families. The alliance is also concerned about the lack of sustainable funding for many services. These are fundamental services providing vital care for women; they are not luxury extras. We need to ensure that in all parts of the country, women who have experienced birth trauma and are struggling with their mental health have access to specialist support, and that there is continued funding in every area to meet the level of need that we know is out there. That is the alliance’s ask of the Minister.

I want to make it clear that I am not saying we do not appreciate the vast majority of our NHS and healthcare workers. Labour believes that the NHS is the backbone of our country, and will never abandon the founding principles of the NHS as a publicly funded public service, free at the point of use. However, as with so many other issues, this Government are presiding over a healthcare system that is going backwards rather than forward. It is the Government’s role to break down barriers and solve the difficult problems that we face, but it sometimes seems that those barriers are becoming higher and higher.

I want to raise with the Minister some concerns about the women’s health strategy. It lacks a plan to tackle the increasing waiting lists and a plan to enhance maternity care standards, and it fails to address the persistent staffing shortages. As my hon. Friend the Member for Enfield North (Feryal Clark) has said previously, it is plainly inadequate. The Royal College of Midwives told me this week that fundamental to delivering better maternity care is having enough midwives. The fact is that midwives are leaving the profession in droves, and the Government are failing to stop it happening. The Minister must tell us how she plans to keep the staff whom we currently have and ensure that the problems do not continue to worsen.

On top of those shortcomings, there is the problem that when a mother needs mental health support, the resources simply are not there. Midwives do not have the expertise or the time, and the result is that parents’ mental health is not being fully assessed. Overall, patients seeking mental health treatment spent more than 5.4 million hours waiting in A&E in 2021 and 2022. The reality is that patients are waiting or being overlooked rather than getting the support that they need. It is therefore no surprise that the deputy chief executive of NHS Providers has said that mental health services are over- stretched and understaffed, and that trusts are deeply concerned about the levels of unmet need. We need measures to address all these problems early.

Let me end by again congratulating the hon. Member for Stafford on securing the debate. I know it is not easy for her to share her story, and I hope she feels reassured that she has taken a significant step today in raising such an important issue.