Failure to listen to patients' concerns continues to plague maternity services

I was recently involved in the terrible case of an Asian woman who went to see her community midwife in the 40th week of her pregnancy with severe pre-eclampsia symptoms, including swelling in the hands, feet and face, reduced fetal growth, and a transverse lie (i.e. when the baby lies horizontally rather than vertically across the uterus).

Put together, these are clear warning signs that something is wrong; according to the NHS' own website, the earlier pre-eclampsia is diagnosed and monitored, the better the outcomes for both the mother and her baby.

The woman did not speak English and an interpreter was present during the examination. 

The midwife was worried enough to call the hospital's obstetric unit and relay her concerns, but the doctor dismissed this and refused to review the woman later that same day. She was instead booked in for an ultrasound scan six days later, on her estimated delivery date.

Tragically, the day before the due date, her baby died in utero. The hospital's own internal report acknowledged that had the doctor listened and our client had been reviewed that day, it is likely that her baby would have survived.

Unfortunately, my colleagues and I in Fieldfisher's medical negligence team regularly encounter cases of pregnant women who feel that their concerns go unheard; sometimes with devastating consequences that last a lifetime. 

This sentiment is echoed by the recently published Birth Trauma Inquiry which, like previous reports, notes that poor communication and not being listened to are repeatedly cited issues in maternity healthcare. As reported by my colleague Heidi Brotherton, our team's first-hand experience is that this feeling of poor treatment and dismissal is particularly prevalent among many Black and Asian maternity patients, who experience worse care and frequently encounter a lack of cultural awareness from medical staff.

What we hear from clients is that this often arises between treating clinicians and patients, but also between treating clinicians and midwives, such as in the example provided above, where the midwife's concerns were dismissed by the obstetrician. This is despite the implementation of Martha's Rule in April 2024, designed to ensure that the concerns of the patient and those who know them best are listened to and acted upon.

This failure to listen to women's concerns particularly continues to be a key issue for maternity services nationwide. Hopefully by repeatedly highlighting our clients' stories, we can eventually obtain meaningful change in how obstetricians and midwives deal with mothers. 

Read more about our stillbirth, neonatal death, and birth injury claims.