A recent review of maternity care in England has uncovered a concerning trend: nearly half of the serious failings leading to infant deaths involve inadequate foetal monitoring during labour, according to the Care Quality Commission (CQC).
The CQC’s analysis, part of its Maternity and Newborn Safety Investigations (MNSI) program, revealed that in 49% of cases where a baby died or suffered severe brain damage in midwife-led units, proper foetal monitoring was lacking.
Sandy Lewis, director of the MNSI program, emphasized the critical importance of accurate monitoring in ensuring the safety of care across all maternity units. The report, aimed at guiding improvements in care quality and safety, identified four common failings in the 92 cases examined.
Among these cases, one highlighted prolonged abnormalities in foetal heart rate that went unnoticed during intermittent monitoring. In another instance, midwives were overwhelmed with an emergency, neglecting recommended monitoring intervals, leaving a woman unattended.
Of the 92 incidents reviewed, 62 resulted in severe brain injury to the newborn, 19 in stillbirth despite being alive at the onset of labor, and 11 in infant death within the first six days of life.
Lewis acknowledged the concerns this report may raise among pregnant women and their families but stressed that despite these findings, thousands of pregnancies, labors, and births during the same period were safe.
Short staffing and heavy workloads in maternity units were also flagged as significant contributors to lapses in care. Calls from the Royal College of Midwives and the Commons health select committee to recruit 2,500 more midwives to address these issues have been noted.
The NCT parenting charity echoed these concerns, attributing compromised monitoring due to overworked and understaffed midwives as a key factor in unsafe maternity units.
Maxine Palmer, head of service development at NCT, emphasized the importance of consistent care standards across different birthing settings, urging that compromises in routine care during labor, such as frequent monitoring of foetal heart rate, pose significant risks to safe care delivery.
