England's Maternity Crisis Deepens as Birth Injury Rates Reach Record Highs

England's Maternity Crisis Deepens as Birth Injury Rates Reach Record Highs

Women giving birth in England are now facing the highest risk of sustaining serious injuries during childbirth since the NHS began tracking such data in 2020, according to newly released figures that are intensifying pressure on health authorities to act decisively.

Record Rates of Severe Tears and Haemorrhage

The statistics paint a troubling picture. The incidence of third- and fourth-degree perineal tears — the most severe category of childbirth-related lacerations — climbed to 31.1 per 1,000 births in the first quarter of 2025, marking the highest rate recorded since monitoring began five years ago. When data collection started in June 2020, that figure stood at 25 per 1,000.

Equally alarming is the rise in postpartum haemorrhage, defined as blood loss exceeding 1.5 litres. The annual rate reached 31.65 per 1,000 births in 2024, up from 25.6 per 1,000 when figures were first gathered. Early 2025 data shows a rate of 31.2 per 1,000 — still among the highest on record.

Calls for a National Crisis Declaration

Liberal Democrat health spokesperson Helen Morgan, who obtained the figures directly from NHS England, issued a stark warning about what the numbers represent in human terms.

"Behind these statistics are women going through unimaginable trauma, requiring surgery and in many cases months or even years of recovery," she said. "Some will never fully recover. This shows that we need to treat maternity services as a national crisis. We will not reverse this dangerous, unacceptable trend until we make safety a priority."

The Department of Health and Social Care acknowledged the seriousness of the findings, stating that "too many women are being failed by poor quality maternity care" and describing the trends as "concerning."

Government Report and Potential Maternity Commissioner

The release of this data coincides with the anticipated publication of a government-commissioned report by Lady Amos examining the current state of maternity care across England. The report is expected to amplify existing demands for a sweeping overhaul of childbirth services.

There is growing speculation that Donna Ockenden — the senior midwife and patient safety expert who recently delivered a scathing review of the NHS's largest-ever maternity scandal at Nottingham University Hospitals NHS Trust — could be appointed as England's inaugural maternity safety commissioner. In that role, she would oversee efforts to raise standards and improve patient safety across the sector. Ockenden is currently investigating additional emerging maternity scandals in Leeds and Sussex.

The government has committed to releasing a comprehensive action plan to reform maternity services before the year's end, though campaigners are pushing for concrete details to be shared far sooner.

In a related development, authorities have expanded Martha's Rule to cover every maternity and neonatal unit in England, granting women and families the legal right to request a second medical opinion regarding the care of a mother or newborn.

Expert Perspectives on the Rising Numbers

Not all specialists interpret the data as an unambiguous sign of deteriorating care. Dr. Kim Thomas, Chief Executive of the Birth Trauma Association, noted that a portion of the increase in recorded tears may stem from improvements in diagnosis rather than a genuine worsening of outcomes.

"The NHS has been rolling out a care bundle encouraging hospitals to identify and treat such injuries more promptly," she explained. "I don't necessarily think that the apparent increase in third- and fourth-degree tears is a sign of worsening maternity services, though it may be."

Additional contributing factors may include the higher average age of mothers giving birth, the elevated susceptibility of Asian women to perineal trauma, and England's comparatively high rate of forceps deliveries — all of which can increase the likelihood of injury.

Critical Gaps in NHS Birth Data

Adding another layer of concern, an investigation by the Guardian uncovered significant deficiencies in how the NHS records birth outcomes. Of the 542,235 births that took place in England during 2024-25, the outcomes of more than 85,000 — nearly 15% — were absent from the NHS Hospital Episodes Statistics dataset. A similar gap existed the previous year, with data missing for over 100,000 of the 545,149 recorded births.

The missing information encompasses details such as delivery location, method of birth, infant birth weight, anaesthetics administered, and gestational age at delivery. Some NHS trusts have also been found to be filing incomplete records with the separate Maternity Services Dataset.

Clare Livingstone, Head of Professional Policy and Practice at the Royal College of Midwives, stressed the severity of this issue.

"Incomplete data is a fundamental barrier to improving maternity care," she said. "Without a full picture of what is happening before, during and after birth, it is much harder to identify where action is needed — and these figures point to a significant gap in NHS maternity data."

As political and public pressure continues to mount, the coming weeks are likely to prove decisive in shaping the future of maternity services across England.