The dark underbelly of maternity care in the UK has been laid bare by new research, highlighting how ingrained prejudices, including misogyny and racial bias, are putting mothers and babies at risk. A damning report into the Ockenden inquiry into Nottingham University Hospitals NHS Trust revealed over 500 instances of harm or death to women and their newborns due to substandard care.
Studies by academics from Manchester and Sheffield universities have uncovered disturbing evidence that women's concerns about their health are being systematically disbelieved. This is largely due to pre-existing biases, which lead healthcare professionals to perceive women as overly anxious, hysterical or irrational. As a result, physical symptoms can be dismissed as psychological or ignored altogether, leading to delayed or incorrect diagnoses and treatment.
Racial stereotypes further exacerbate this problem for Black and other ethnically non-white women. The worrying trend of assuming that certain ethnic groups possess higher or lower pain tolerance is having a devastating impact on maternity care. This misconception can lead to inadequate pain relief during labour, leaving expectant mothers even more vulnerable in an already perilous situation.
The cumulative effect of these biases means that women's 'testimonial knowledge' – their own understanding and communication about their bodies and experiences – is consistently devalued and deemed unreliable. Despite numerous inquiries highlighting the need to give women a voice in their maternity care, systemic issues persist where their voices are not adequately heard or acted upon.
Concerns have also been raised regarding accountability within NHS trusts. A consultant in obstetrics and foetal medicine pointed out that over half of executives and many commissioners declined to participate in the Nottingham investigation – despite advocating for transparency. This refusal to engage, coupled with findings of a 'culture of fear' where junior staff were intimidated from escalating concerns, raises questions about senior management responsibility and the effectiveness of current whistleblowing mechanisms within the NHS.
Experts are now urging the implementation of robust measures to regulate safer care within a learning healthcare system. They stress that recognising and integrating women's voices is crucial in developing safe and compassionate maternity services. Without such changes, the risk remains that systemic medical misogyny will continue to have devastating consequences for women and their families across the country.
According to NHS England data, between 2015 and 2020, there were over 2,000 stillbirths or neonatal deaths in England, with many more experiencing long-term physical and emotional harm. The Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) have called for a comprehensive overhaul of maternity services to address these systemic issues.