Hospital beneath investigation for poor maternity care chased ‘pure delivery’ ideology that ‘led to new child deaths’
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An NHS hospital at the centre of an investigation into poor maternity care spent a decade chasing a ‘normal birth’ ideology that allegedly led to a spike in newborn deaths.
In the period that Leeds Teaching Hospitals Trust (LHT) had the lowest number of caesareans – between 2012 and 2023 – its rate of stillbirths and newborn baby deaths soared to the worst in Britain.
In its own maternity strategy, published in 2015, hospital chiefs requested maternity doctors to promote a natural or vaginal birth, with minimal medical interventions, The Sunday Times reports.
The approach has been blamed for contributing to poor maternity care amid concerns midwives and doctors were waiting too long to intervene in labour or putting mothers through prolonged use of forceps to avoid a caesarean.
Leeds’s strategy was published months after Morecambe Bay Trust, in Cumbria, was criticised for pursuing normal birth ‘at any cost’ in a damning report into its maternity care.
‘All birth environments will share a philosophy of promoting ‘normal birth’, Leeds’s strategy said.
The hospital’s home birth team still states that ‘we believe that birth is a natural and physiological process’.
Fourteen NHS trusts – including LHT – are at the centre of an investigation into maternity failures in England.
Hundreds of babies have died or been left brain-damaged due to poor maternity care across England. Health Secretary Wes Streeting has described the scandal as a ’cause of national shame’.
Fiona Winser-Ramm (pictured) and her husband Daniel believe a normal birth ideology played a part in the death of their daughter, Aliona, who was killed by serious neglect and gross failures by midwives at Leeds
Mr Streeting last month announced an independent inquiry into the maternity units at LHT.
The parents say they felt gaslit, dismissed and even blamed for what went wrong there.
Mr Streeting said the Government was aware that the ‘culture has been a problem at Leeds’ and around the country, adding that £130million was being spent on improving maternity care.
He said: ‘This stark contradiction between scale and safety standards is precisely why I’m taking this exceptional step to order an urgent inquiry in Leeds.
‘We have to give the families the honesty and accountability they deserve and end the normalisation of deaths of women and babies in maternity units.
‘These are people who, at a moment of great vulnerability, placed their lives and the lives of their unborn children in the hands of others – and instead of being supported and cared for, found themselves victims.’
The families are waiting for the terms of reference of the investigation to be confirmed, but feel the police should be involved.
They also called for it to be chaired by the ‘rigorous’ leadership of midwife Donna Ockenden, who is heading the independent review of maternity services at the Nottingham University Hospitals NHS Trust.
LTH is among 14 hospital trusts which will be examined in a national investigation into ‘failures’ in NHS maternity and neonatal services led by Baroness Amos.
Leeds Teaching Hospitals (LTH) NHS Trust has two maternity units – at Leeds General Infirmary and St James’s University Hospital
A range of services will be put under the spotlight in the investigation, which comes after various independent reviews across multiple trusts found failings, including women’s voices being ignored, safety concerns being overlooked and poor leadership, which has created toxic cultures.
More than 150 families have complained about their maternity care at Leeds.
Fiona Winser-Ramm and her husband Daniel believe a normal birth ideology played a part in the death of their daughter, Aliona, who was killed by serious neglect and gross failures by midwives.
‘Essentially, the steer to continue with a vaginal birth at every opportunity was evident throughout my labour,’ Ms Winser-Ramm told The Times.
An inquest found Aliona, who died on January 1 2020, should have been delivered by caesarean section from 10.30pm on New Year’s Eve, but was not born until 3.32am.
Ms Winser-Ramm endured a 72-hour labour during which midwives dismissed her concerns and failed to act on key warning signs in Aliona’s heart readings.
The inquest heard that there was a ‘wait-and-see culture’ at Leeds.
The rate of caesarean sections at Leeds between 2012-13 and 2023-24 was 19 per cent, significantly lower than the national average of 24 per cent.
Separately, it also had one of the highest rates of spontaneous births – not using instruments or C-sections since 2015-16.
The number of stillborn babies per 1,000 births is among the highest in England at 4.36 compared with the national average of 3.25.
Neonatal deaths have consistently been the highest in the country, going back to 2017.
In the most recent data up to January 2023, Leeds had a neonatal death rate of 5.6 deaths per 1,000 births – the worst of any trust. The average is 1.7.
Dr Magnus Harrison, Chief Medical Officer at Leeds Teaching Hospitals NHS Trust, said: ‘We are deeply sorry to all families who have been harmed in our maternity and neonatal services. We recognise we need to make improvements, and we are committed to providing safe, compassionate and high-quality care to all families.
‘The Trust offers families a choice of delivery options in line with National Institute for Health and Care Excellence (NICE) guidance, and we respond to any changes in this guidance. The last NICE update in 2023 relating to caesarean births included a revision to strengthen the emphasis on supporting the family’s choice, which we follow. We recognise that the number of caesarean births in Leeds during 2023/24 were lower than the national average but we are now seeing an increase in this number.
‘We are committed to conducting an external review of our stillbirth and neonatal mortality (MBRRACE) data to understand more about how we compare with other similar organisations, and whether there are areas we can improve.
‘Following the CQC and MSSP reviews of our services, we have already made a number of improvements in our maternity and neonatal departments and are developing a future improvements programme.
‘We are committed to work openly, honestly and transparently with the independent inquiry into maternity and neonatal services in Leeds, and we want to work with the families who have used our services to understand their experiences so we can make real and lasting improvements.’
