Birth Trauma

Rosie Duffield Excerpts

Thursday 19th October 2023 Commons Chamber

[Rosie Duffield (Canterbury) (Lab)]

First, I wish to thank my lovely hon. Friend the Member for Stafford (Theo Clarke) for securing this debate, for setting up the all-party parliamentary group for birth trauma, for her brilliant speech and bravery, and for generally allowing me to ride chaotically on her incredibly organised coattails.

What is birth trauma? The Birth Trauma Association describes it as

“a broad term applied to those who experience symptoms of psychological distress after childbirth. It includes those whose symptoms qualify for a diagnosis of post-traumatic stress disorder.”

That term certainly applies to the many women who took part in our recent Mumsnet birth trauma survey, which included some statistics that should be of concern to all health professionals, and some shocking stories of women’s experiences. It also certainly applies to those women in east Kent whose experiences contributed to the damning Kirkup review, which was released a year ago in October 2022.

Women who had every right to expect safe and professional care during their pregnancies and labour were badly let down by our health trust, often with life- changing consequences. The poor, sub-standard maternity care received by many families over an 11-year period made for extremely harrowing reading, and I take this opportunity to thank Dr Kirkup and his team for their painstaking work, and for their sensitive and caring approach to the women and families over the course of their investigation. I know that they continue to make themselves available to anyone who may need them, which is in stark contrast to the scandalous way in which those families were often treated at the height of their trauma, and as they struggled to come to terms with what they had been through.

No matter what analysis of each individual case of birth trauma or the findings of reports conclude, one basic requirement should be unchanged in the hospital experience of every single patient: care. Kindness, good manners, information, listening to women—those are not things that should be altered or affected in any way by medical circumstance or emergency. Are such things not in fact even more vital when a panicked or distressed family are faced with a traumatic situation? The way that my hon. Friend was spoken to after her unexpectedly difficult birth—I should not need to stand in this place and explain that it was unacceptable.

For my constituents in East Kent Hospitals University NHS Foundation Trust, which is chronically short-staffed and plagued by low morale and a lack of equipment, those factors definitely contributed to some of those terrible experiences. Basic patient care standards should always apply, and essential staff, no matter how lowly their place in the chain of command, must always be afforded respect by those in authority so that they feel supported and, crucially, are able to raise concerns without the real fear of repercussions.

During the Kirkup inquiry, much of my team’s work was speaking to staff who wished to be contributors but were extremely afraid of speaking out. One midwife went to great lengths to remain anonymous, even buying a burner phone in order to call me in my office. She was very upset and nervous but helped me a great deal by providing background information. Why should a whistle- blower have to be so afraid when her testimony could help to improve standards and practices in our NHS?

The Minister recently attended a discussion with some of the families and mothers who contributed to the Kirkup review in my constituency. I know they felt that she listened and had direct contact, which was so important to them. Their experiences should make every Member here, and every member of East Kent Hospitals University Foundation Trust, determined to improve every aspect of maternal care in our region.

In his “Reading the signals” report, the overriding and most important point that Dr Kirkup stressed was simply, “Listen to women.” Yet those I am still in contact with, although grateful for the acknowledgement and involvement of the Minister and our trust’s new CEO, Tracey Fletcher, still do not yet have faith that services have improved dramatically. Whenever family or my staff members use maternity services in East Kent, I tell them to ensure that their relationship to their MP is mentioned. That should not be something I have to do in order to feel that they might be safe and looked after.

I want to make time to read out direct comments from some of the mothers and families involved in that inquiry, and especially from my former constituent, Helen Gittos. I thank her for her tenacity, her courage, and for continuing to raise issues with me on behalf of those affected. I will end by reading out Helen’s thoughts, emailed to me late last night, as I think that her voice in this debate is far more important than mine. She says:

“Some of the strongest comments tonight have come from those families who are caring for very disabled children. It was Amie Taylor who said this, ‘Personally, I would love them to understand that this has had a profound effect on us all in more ways than seems to have been acknowledged by the Trust, or maybe even the report, from somebody who had a baby with a brain injury following sub-standard care. We are faced with ongoing medical issues and the strain mentally, physically, emotionally, financially, and what may be the other side of this, hasn’t been acknowledged. The impact this has had on our careers, family dynamics, social life—every element of our lives were affected. PTSD, anxiety, depression. I am pretty sure all the families have experience in one degree or another of this.’”

[Jane Stevenson (Wolverhampton North East) (Con)]

My constituent, Tracie Reynolds, lost her daughter Trinity in New Cross Hospital in Wolverhampton 20 years ago, and she has been campaigning on maternity services and indeed has met the Minister. Let me put on record my thanks to my hon. Friend the Member for Stafford (Theo Clarke) and the hon. Member for Canterbury (Rosie Duffield) for bringing forward this debate. I know so many mothers who have struggled, and I wanted to place on record the thanks of my constituent, Tracie, in memory of Trinity and all the babies who sadly are not here. My hon. Friend and the hon. Lady have done an immense service to so many people by bringing forward this debate.

--- Later in debate ---

[Rosie Duffield]

I thank the hon. Lady very much.

Helen goes on to say:

“Staff in the Trust and women with very recent experience say that there has been no real change. One woman said on the Facebook Support Group tonight ‘Having had my 6th baby at William Harvey Hospital this August I can say very little has changed 1 year on’.

What we have seen so far is action plans but not actions—exactly the kind of checklist, tick-box exercise Bill Kirkup said doesn’t work. I and others do not think the core messages of Reading the Signals have been understand—let alone acted upon. Clinical leadership is absent. New Head of Midwifery and her Deputy seem excellent but the doctors are just not present—they are not writing the action plans, not attending the Reading the Signals Oversight Group meetings, just really absent. How can the Government say that they accept the findings of the report when NHS Resolution—who act on their behalf—are not accepting the findings?”

The Minister and I heard that when we spoke directly with those families. Helen continues:

“How can the Trust say that they are concerned about patient safety when lawyers acting on their behalf continue to behave appallingly at inquests? In the case of Archie Batten they tried to argue he was stillborn and therefore there should be no inquest. In the case of Maya Siek in September, they argued there was no need for it to be an Article 2 inquest.”

That comes up time and again, as the Minister knows. Those women want the law to be changed so that stillborn births have to have an inquest.

Helen says:

“One family involved in this said on the Facebook group tonight: ‘Personally, I would love them to understand that this has had a profound effect on us all in more ways than seems to have been acknowledged by the Trust, or maybe even the report”.

I earlier mentioned that her child had a brain injury. Helen continues:

“Another simply said this: ‘This last year has caused so much turmoil for so many I hope that comes out somewhere.’ I think that really captures the experience of so many people involved—and that turmoil has been partly because people’s experiences of engagement with the Trust continue to be so problematic. But I think the Kirkup report provides us with a plan. And that rather than get side-tracked into an expensive, time-consuming public enquiry, we should all put our collective effort into enacting its recommendations. If we did, things would get better.”

I thank the House for its indulgence; this is a really upsetting debate.

--- Later in debate ---

[Cherilyn Mackrory (Truro and Falmouth) (Con)]

First, I thank my hon. Friend the Member for Stafford (Theo Clarke) for securing the debate, and I thank her and the hon. Member for Canterbury (Rosie Duffield) for establishing the all-party parliamentary group on birth trauma. I co-chair the all-party parliamentary group on baby loss, and it is surprising, and remiss of us, that we have never focused on birth trauma as part of the work of that all-party parliamentary group. That could be why it did not feature heavily in the Government’s women’s health strategy. I am therefore thankful that my hon. Friend has brought the subject to Parliament front and centre and that we are talking about it.

I pay particular tribute to my hon. Friend for sharing her story. It was three years ago in my first Baby Loss Awareness Week debate that I stood in Westminster Hall and told my story, not realising how much it gets to you when you are speaking in a very quiet Chamber and in public. I was thankful to colleagues for intervening on me on that day so that I could just get through. So I understand exactly where she is today and think she has been incredibly brave. I hope that she continues to use the force she has inside her for good.

I also thank the hon. Member for Canterbury, who is clearly a powerful advocate for her constituents. It is appalling that her friends and family need to drop her name as they go to hospital for what should be a routine procedure—if we want to call labour a procedure. I am sorry that they have to do that, and I hope that the voices in this place will mean that that will not be case for much longer.

I thank my hon. Friend the Member for Moray (Douglas Ross) for highlighting what is a difficult time for dads. Listening to his speech made me think that, when we lost our baby, even though my husband was with me all the time, they did not ask for his opinion at all. Had he not been there, would they have done? I am not sure. I thank my co-chair of the all-party parliamentary group on baby loss, the hon. Member for North Shropshire (Helen Morgan), for her collaborative work on all things baby loss, and for sharing her story. She highlighted how dangerous labour and birth is. It has never been safe. We just did not evolve very well as a species in that regard. It is thanks to medical advances that we save as many babies and women as we do today in this country.

[Rosie Duffield]

Does the hon. Lady agree that the scandal of maternal deaths among black and ethnic minority women is especially horrific? We need to work with groups such as Five X More and highlight that in this place as often as we can, to end it as soon as we can.

[Cherilyn Mackrory]

I absolutely agree. We have done some work and a few inquiry sessions on that in the all-party parliamentary group. The disparity is outrageous. The Government are trying to put in place plans such as continuity of care, which I will come to. It is a particular passion of mine and I will speak about it a little later.

Since becoming the Member of Parliament for Truro and Falmouth, I have made it my mission to champion as many women’s health issues as I can, particularly baby loss. I have often talked in this place about what happened to me, though I will not go into my story today for fear of not being able to get through my speech. We have just had Baby Loss Awareness Week, which we will talk about in the next debate. Tackling often avoidable birth trauma is an integral part of that mission. Bringing life into this world is the most precious thing. Where women have unfortunate experiences, we must make sure that adequate measures are in place to support them and the mental health of their families. I thank all the women who have come today to support my hon. Friend the Member for Stafford and the work she has done for every one of them. It is a brave move to come forward and talk about your story, let alone collaborate, come to this place and advocate for other women who are watching at home. I thank them.

Every woman is different. The freer the flow of information between mothers and their doctors, the more tailor-made and informed the health provision can be. I am reassured that work has started in this space to start to empower women through informed maternity decisions. We have outlined that in documents such as the “Safer Maternity Care Progress Report 2021” and further progress reports over the last two years.

I have been particularly reassured and impressed by the engagement of our Minister through the various all-party parliamentary groups on women’s health. Let me take this opportunity to thank all colleagues who have been involved in boosting maternity issues. We are lucky to have a Minister who understands this area completely, having worked in the sector. She does all she can to keep us informed of developments, and when we do not get things right, she takes it on board.

Delivering a more informed maternity provision in our hospitals has the potential to reduce birth trauma caused by inappropriate methods of birth for a specific mother with specific needs, which is even more important when considering that seven in 1,000 babies born to black mothers are stillborn. If we are able to provide evidence-based information to mothers from all backgrounds on what options best suit their needs, we will undoubtedly get to grips with the inequalities in pregnancy outcomes.

In my role as chair of the all-party groups I mentioned, I have heard so many stories from women about their experiences. Some are simply traumatic and some should never be allowed to happen again. When my hon. Friend the Member for Stafford told me she would come forward with her story and had the fire inside her to start a campaign, I gave her a word of warning from when it happened to me. You tell your story once, and you think you can pack it away until you need to think about it again. When you are constantly talking to other people who have been through a similar thing, you are constantly thinking about your own experience as well. Some days you can put on a front, put your armour on, get through it and be that shoulder for them to cry on. Other days it is not as easy. My advice to anyone who has been through it is to look after yourself first, please. You cannot look after others unless you have looked after yourself.

In so many of these stories, women talk about their excitement for what is to come, and the search for answers afterwards when things go horribly wrong. We have a duty to make sure that every time an expectant mother visits a hospital, midwife or local GP, they receive full and proper advice from someone who is fully informed about their case. That is why I come to continuity of carer. It has been proven to work. In areas of the country where we have high numbers of mothers living in social deprivation or ethnic minority mothers, it has already been put into practice by the Royal College of Midwives and various health trusts. We know that it works, but the problem at the moment is the lack of midwives to roll it out nationwide. The Minister is alive to this; she understands it. We are seeing more young people going into midwifery. We have a lot of first-year students at the moment. I am pretty confident that in the years to come we will start to see more midwives deployed on wards, and continuity of carer will start to become a reality.

Really, the message is simple to any healthcare professional: just listen to women. Listen to those who advocate for women when they are in labour. Just listen. If you can, listen rather than think you know what is going on. Taking a step back, listening to what is happening and having a conversation rather than rushing and panicking often leads to a better outcome.

My hospital, the Royal Cornwall Hospital in Treliske in Truro, has improved its maternity care a lot in the last 10 to 15 years. We are also getting a new women and children’s hospital as part of the new hospital programme. Thanks to those two factors, unlike other parts of the country we have no midwifery vacancies in Cornwall. Not only that, we have a waiting list of people wanting to be midwives. I pay tribute to Kim O’Keeffe, the chief nurse officer and deputy chief executive of the hospital, and all her team, for their relentless work in this space. They are working in a decaying building at the moment, but even so we are in a much better place than we have been. The women in Cornwall who are to give birth are in a much better place than they were 10 to 15 years ago.

I want to put on record just how desperate birth trauma is. Even a healthy birth—like my first birth—is a shock if you are not expecting it. It is something that happens to you; you have no idea what is happening. Even afterwards, if it is all fine, you think, “My God, what just happened?” It is a shock that can still bring on post-natal depression, because of the relentlessness of looking after a brand-new baby. I have had two pregnancies and two births: one straightforward live birth, and the second a stillbirth. That was a straightforward birth physically, but mentally completely traumatic, because I knew I was giving birth to my baby who was not alive. I had to recover from that and grieve, and I knew what was wrong: my baby was not well enough to survive. The shock was over a whole weekend rather than a matter of hours.

We have heard stories today, and I will briefly tell the story of someone very close to me. She was seen as low risk, rushed into hospital and the baby was stuck in the birth canal. She was rushed in for an emergency section. Her husband was nowhere to be seen, because he was sidelined. There was a loss of blood. It took my friend six years before she would fall pregnant again. Luckily, she has a new baby—a little brother—who was born last month. She was frightened all the time about premature labour and whether it could happen again, and whether she should get pregnant again. After my stillbirth, I was too scared to get pregnant again, and I already had a daughter so I did not. It is different for every woman and family; there is not one fix for everyone.

I go back to my previous point that we just have to listen to women. All the services around maternity, during labour and afterwards, including counselling services, must be there because the woman—or the birth partner, the dad—has asked for them. Some women will sail through everything and be fine, but some will not. We need to ensure that, regardless of what they ask for, we are listening.