Is overcoming inequalities in maternity care as simple as ABC?

In September 2024 the Care Quality Commission published its National Review of Maternity Services in England 2022 to 2024. This found that out of the 131 maternity units inspected by the CQC,  47% were rated as substandard (with 36% rated ‘requires improvement’ and 12% rated ‘inadequate’). In fact only 4% of maternity services were rated as ‘outstanding’. 

The CQC highlighted several trends which had come out of the data: 

• When incidents occurred, women did not always receive the information they needed to process what had happened and make informed decisions about future pregnancies;  
• there was significant variation for maternity triage which meant many women experienced significant delays; 
• chronic issues around recruitment and retention of staff; 
• some maternity units were not fit for purpose, lacking space and equipment to ensure high quality births; 
• there were differences in the way trusts collect and use demographic data to address health inequalities in their local populations. It has been found that black women are 2.8 times more likely to die during pregnancy or in the 6 weeks following pregnancy compared to White women;  
• women were not always given the information they needed, in a way they can understand it, to make informed decisions and consent to treatment.

On 7 October 2024 the government launched The Avoiding Brain Injury in Childbirth (ABC) pilot across 12 maternity units with the aim to improve maternity outcomes for women and babies by reducing the incidents of brain injury in childbirth. In addition to reducing incidents of harm to patients, it was also hoped that improving maternity services would reduce the cost of clinical negligence claims.  

The pilot scheme provided £7.8 million in government funding for training to help maternity staff better identify and act quickly when babies were in distress during labour and to deal with obstetric emergencies. The main focus was to bring multidisciplinary maternity teams together and to encourage greater collaboration.  

Today, the government has announced that it will be rolling the ABC scheme nationally from September 2025. Health Secretary, Wes Streeting stated: This vital programme will give staff across the country the right tools and training to deliver better care to women and their babies, reducing the devastating impact of avoidable brain injury. 

The government have pledged to deliver rapid improvements in maternity care and to train thousands more midwives. It remains to be seen whether these good intentions will be realised. 

In the meantime, delays and failings in maternity care remain all too common. 

If you have experienced poor maternity care and have questions about making a clinical negligence claim then please feel free to drop me a message or alternatively, contact the clinical negligence team at Clarke Willmott.