As recently reported by BBC News, in the last two years thousands of women and babies have been harmed as a result of mistakes made by their maternity care providers.
Between April 2015 and March 2017, hospital staff logged over 276,000 incidents. This is equal to one mistake occurring for every five births, or 400 errors per day.
Mothers And Babies Harmed By Maternity Care Providers
Most of the mistakes were minor, but almost 25% of the errors led to either the mother or baby being harmed. Almost 300 deaths occurred as a result of mistakes made by hospital staff.
The mistakes were logged as part of a voluntary reporting scheme, run by regulator NHS Improvement. Under those circumstances, it’s likely the actual number of errors is much higher.
These are some of the mistakes reported:
- Records were not completed correctly
- Babies were deprived of oxygen
- Life-threatening complications went undiagnosed
- Mistakes were made during c-sections and other interventions
- Women were given incorrect medications or doses.
Isn’t Hospital Birth Safe?
For most women in high income countries such as the US and Australia, hospital is the place to go to give birth. For some women, depending on where they live, hospital is the only option, as governments have taken away other out-of-hospital birth options.
Women are encouraged to give birth in hospital because it’s safe. If things go wrong, there is access to emergency medical services, which can save lives.
We want to believe birth can be completely risk free. Many women choose to birth in hospital with the idea they are completely safe from harm. This complete trust in their care providers is ideal, but it doesn’t protect women from being harmed when the providers are unable to meet these expectations.
A hospital, by its nature, is a place that works against everything that is intrinsic to a normal, natural birth. The environment, its regulations and policies, overworked staff and staff shortages are all factors that regularly affect an individual woman’s experience.
Underlying all of these factors is the mainstream model of care, which views birth as a medical event rather than a normal, physiological process.
The model is seen as normal and acceptable, because of a commonly held perception: it is much safer to birth in a hospital setting than outside of it.
This view persists, despite studies showing birth outside of a hospital setting – such as planned home birth – with the help of a professionally trained midwife, is just as safe. In some cases it is even safer than birthing in a hospital.
Mistakes made during home births are inevitably reported with sensational headlines, whereas those made in hospitals rarely make the news.
How Do Mistakes Happen?
We all make mistakes. The people who bear the brunt of our mistakes, however, find it hard to accept this is true – particularly if the consequences are dire.
We tend to think of hospitals as places were mistakes are fixed. How, then, do mistakes happen in hospitals?
The reasons are many and varied. Most relate to problems with time, systems and resources. Human error is unavoidable and hospital systems are run by people who are fallible.
It is undeniably true hospital staff are there to look after each woman and baby, and to ensure birth happens safely. Unfortunately the framework in which they provide care puts pressure on them, and affects how care is delivered.
In a hospital setting, a woman is unlikely to know the staff caring for her during labour. The staff won’t know her well either. Regardless of her individual circumstances, she will be expected to meet a series of checkpoints, which, according to the hospital’s policies, will reduce the risk of things going wrong. She might experience interventions, to keep her labour on track with what is expected, even if current evidence no longer supports those expectations.
Mistakes are made because hospitals might not be staffed to cope with the numbers of women having babies. They aren’t equipped to give each woman the individualised and personal attention she needs to give birth successfully, on her own terms.
Staff might also be tired, overworked, and overwhelmed.
The role of the UK’s Care Quality Commission is to inspect hospitals. In its most recent review, it expressed its concerns about staffing levels and the lack of provision of one-to-one care during labour.
Half of all maternity units have been judged as unsafe.
What Is The Answer?
Can we completely avoid the possibility of mistakes occurring in hospitals? Probably not.
We can, however, address the current mainstream model of maternity care, and ask how it contributes to avoidable errors.
Instead of telling women hospital is the only safe place to give birth, we should admit this isn’t true for all women.
Those women who can safely birth outside a hospital setting should be supported to explore this option. Care providers who provide out-of-hospital maternity care should also be supported by relevant health authorities.
It is no secret: women are being let down by the system they are supposed to trust. Mistakes can’t be completely taken out of the equation, but it’s possible to ensure avoidable mistakes are minimised.
What do you think?
Should maternity hospitals be forced to reveal their errors, to improve accountability and allow women greater choice?