Toxic Culture and Offensive Language Exposed Inside Nottingham's Troubled Maternity Unit

Offensive Codes and Disturbing Attitudes Uncovered at Nottingham Maternity Unit

An explosive new investigation by BBC Panorama has brought to light deeply troubling behavior among maternity staff at Nottingham University Hospitals NHS Trust (NUH), including the use of offensive shorthand to pressure vulnerable pregnant women into leaving the hospital before receiving proper care.

A Three-Letter Code That Said It All

Among the most disturbing revelations is the use of a crude acronym — "FOH" — written on a whiteboard beside the names of heavily pregnant women. Far from indicating a medical condition or care requirement, the letters stood for an expletive-laden phrase urging women to leave the maternity unit. The first letter represented a common swear word, followed by "OFF" and "HOME."

This offensive shorthand was first documented in a resignation letter written in 2018 by a senior midwife, a document now obtained and reviewed by Panorama. The same letter detailed another alarming piece of advice reportedly shared among colleagues: when pregnant women called the unit worried they were going into labor, staff were allegedly encouraged to send them home with the mindset — "Don't be too kind, she'll keep coming back."

The Largest Maternity Inquiry in NHS History

NUH, which operates both City Hospital and Queen's Medical Centre in Nottingham, currently sits at the center of the most extensive maternity inquiry ever conducted within the NHS. The investigation, led by senior midwife Donna Ockenden, is examining the care delivered to approximately 2,500 families between 2012 and 2025. Its scope covers stillbirths, neonatal deaths, maternal fatalities, and serious injuries to both babies and mothers.

The inquiry's findings are scheduled for release on 24 June. Speaking to Panorama ahead of publication, Ockenden did not hold back her assessment of the trust's internal culture.

"Nottingham thought that there was a Nottingham way — that they were some kind of superior NHS trust compared to others," she said.

Anthony May, the trust's current chief executive — who was not in his role when the alleged incidents occurred — has publicly committed to addressing the failures, telling the BBC: "We need to take accountability as an organisation."

Deadly Consequences of Turning Women Away

A recurring thread throughout the inquiry and witness testimonies is a deeply embedded culture of discouraging women from being admitted to hospital, even when they were in active labor or experiencing serious complications.

One former midwife recounted a particularly heartbreaking case in which a woman called the hospital reporting she was in labor, only to be told she did not need to come in. By the time she arrived, it was too late.

"When she came in, her baby was dead. The mother's perineum and vaginal wall had collapsed because she had been left to labour for so long. She now has a stoma bag," the midwife told Panorama.

This account is one of many highlighting how a policy of keeping women at home for as long as possible directly contributed to tragic and preventable outcomes.

Families Left Devastated by Ignored Warnings

Panorama shared the contents of the 2018 resignation letter — including the FOH acronym — with Sarah Hawkins, whose repeated concerns were dismissed over six days before her daughter Harriet was stillborn in 2016.

Her reaction was raw and immediate.

"That's quite upsetting for me to hear. The last phone call I made to a ward manager, she might as well have just said that to me," Hawkins said, referencing the three-letter code. "Who writes that in a caring profession?"

A Culture of Bullying, Neglect, and Indifference

Testimonies gathered from ten former NUH midwives paint a consistent picture of a toxic, bullying-driven environment that persisted within the maternity services for years.

One midwife described an incident in which a junior colleague was promised support while caring for a high-risk patient — only to be left completely alone when she called for help. Meanwhile, senior staff were allegedly "shopping for handbags online."

Beyond poor attitudes, chronic understaffing created dangerous working conditions that further eroded the quality of care.

"They would say the levels of staffing were safe, but they definitely weren't," said a community midwife who was frequently redeployed to the trust's maternity units to cover shortfalls. She added: "You have to be resilient, and to be resilient you have to lower your compassion."

Staff Trauma Overlooked

The emotional toll on staff was also largely ignored by management. One midwife shared that she was ordered back to the labor ward to deliver babies — shortly after personally suffering a late miscarriage.

"There was a lack of empathy, interest and care," she recalled.

Another described the unit as "a frightening place to work," where relentless shift pressures caused professional standards to slip dangerously. A fifth midwife revealed she was sometimes the only person on an entire shift qualified to interpret fetal heart rate monitoring — a critical skill in identifying babies in distress.

A System That Failed the Most Vulnerable

Taken together, these accounts reveal a maternity unit in which institutional arrogance, chronic understaffing, and a corrosive internal culture combined to put thousands of mothers and babies at serious risk. As the Ockenden inquiry prepares to deliver its landmark findings, the testimonies emerging from Nottingham serve as a stark warning about what happens when patient care is subordinated to institutional convenience.