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NHS must disclose risks of giving birth in midwifery-led unit, Donna Ockenden warns

Donna Ockenden, the midwife whose inquiry linked more than 200 baby deaths to failings by Shropshire and Telford Hospital NHS Trust, has spoken on The Telegraph's Planet Normal podcast - Jacob King
Donna Ockenden, the midwife whose inquiry linked more than 200 baby deaths to failings by Shropshire and Telford Hospital NHS Trust, has spoken on The Telegraph's Planet Normal podcast - Jacob King

The NHS must warn pregnant women about the risks of giving birth in a midwifery-led unit separate from a hospital, the midwife who led a damning review into baby deaths has said.

Donna Ockenden, whose inquiry linked more than 200 baby deaths to failings by Shropshire and Telford Hospital NHS Trust, said she uncovered “many” cases where expectant mothers were wrongly encouraged to give birth in remote units.

So-called freestanding midwifery-led units are typically housed on a separate site or building from a hospital to provide a more comfortable and homely feel, but without access to obstetric, neonatal or anaesthetic care.

It means women who suffer complications need to be transferred to hospital, a delay that can have potentially fatal consequences for mother or baby.

In an interview with The Telegraph’s Planet Normal podcast, Ms Ockenden highlighted the case of Rhiannon Davies, who lost her baby, Kate, after giving birth in a remote unit.

Ms Davies - who, along with her husband, Richard Stanton, was instrumental in getting a full inquiry into the trust’s failings established - had not been recognised as high risk by two midwives. Kate died following delivery in 2009.

Ms Ockenden said: “We saw many cases…where women were encouraged to have babies in remote, midwifery-led units where actually the clinical signs were such that it was very clear they needed consultant-led care.”

She called for pregnant women to be given accurate information about the risks involved, which would involve trusts working with ambulance services to work out how often they are transferring expectant mothers with complications to hospitals.

Need for ‘honest conversation’

“There does need to be an honest conversation that in some circumstances the delay in transfer time may lead to a situation that is less favourable for mother or baby if one or other of them becomes critically unwell," she said.

She added that she would support “the further development of midwifery-led units alongside the labour ward”, but said women “absolutely have the right to choose a birth outside hospital”.

Guidance from the National Institute for Health and Care Excellence (Nice) released in 2014 said midwife-led care was safer than hospital care for women having “straightforward, low risk, pregnancy”.

However, the Ockenden review highlighted a study which reviewed deaths at freestanding midwifery-led units and those alongside units with consultants, which found “in 75 per cent of deaths improvements in care were identified that might have made a difference to the outcome for the baby."

Ms Ockenden’s comments come as she prepares to investigate a new maternity scandal in Nottinghamshire.

An inquiry into maternity services at the Nottingham University Hospitals NHS Trust was announced last summer, amid concerns over the deaths of 30 babies.

But more than 450 families have now come forward, with bereaved parents raising concerns that the ongoing review was “not fit for purpose”.

Listen to Planet Normal, a weekly Telegraph podcast featuring news and views from beyond the bubble, using the audio player at the top of this article, or on Apple PodcastsSpotify or your preferred podcast app.