The Amos Report has exposed a deeply disturbing reality: unacceptable maternity care failings are prevalent across England. Lady Valerie Amos' comprehensive review paints a bleak picture of systemic problems that have led to tragic consequences, including stillbirths, serious injuries, and maternal deaths.
NHS data reveals a concerning trend: the rate of maternal deaths in the UK stands at approximately 12.8 per 100,000 maternities – a figure 20% higher than the 2009-11 average. This increase is particularly striking given the government's goal to halve the maternal mortality rate in England by the end of this year. In comparison to other European countries, the UK's maternal mortality rate is notably high; research published in 2022 found it to be the second highest among eight nations studied, with mothers here three times more likely to die around the time of pregnancy than those in Norway.
The Amos Report also highlights a rise in serious complications following labour. Postpartum haemorrhage (severe bleeding after birth) has increased by 19% since 2020, affecting 32 women per 1,000 births. Similarly, the number of mothers experiencing third- or fourth-degree perineal tears during delivery rose by 16%, from 25 in 1,000 in June 2020 to 29 in 1,000 this year.
The review's findings identify chronic understaffing and entrenched issues like institutional racism as key factors contributing to unacceptable care. A shortage of midwives is a pressing concern, with the Royal College of Midwives reporting a national gap of 2,500 staff across England. Meanwhile, graduate midwives struggle to secure employment – paradoxically, one in three are unable to find work. Inspections by the Care Quality Commission (CQC) reveal that 36% of NHS maternity services require improvement, while 12% have been rated as inadequate.
The Amos Report sheds light on existing inequalities in maternity care. Black women are almost three times more likely to die during childbirth than their white counterparts, and those from the most deprived areas face double the risk of maternal death compared to women from more affluent backgrounds. The increasing prevalence of caesarean sections – now accounting for 45% of all births – is also a potential factor contributing to complications.
This report builds on previous investigations into maternity care failings, including Donna Ockenden's work at Shrewsbury and Telford NHS Trust in 2022 and Nottingham University Hospitals NHS Trust. These studies have exposed avoidable harm to mothers and babies, highlighting the need for fundamental change within England's maternity services.