Birth injuries and maternity negligence: The impact of midwife shortages in the UK

The UK’s maternity services are facing a critical challenge: a persistent and worsening shortage of midwives. This staffing crisis directly impacts the standard of care received by mothers and their newborn children across maternity and neonatal services, increasing the risk of maternity negligence where care falls below expected standards.

What is maternity negligence?

Maternity negligence is when the care provided during pregnancy, labour, or postnatal recovery falls below the standard expected of a reasonably competent healthcare professional, resulting in harm to the mother or baby. This can include failures to monitor vital signs, respond to complications, or escalate concerns.

While not all adverse outcomes are due to negligence, when substandard care leads to preventable birth injury or maternity trauma, it may form the basis of a legal claim.

A system under strain

According to the Royal College of Midwives (RCM), there is a significant shortfall in NHS midwifery staff in the UK. Despite thousands of newly qualified midwives entering the profession, many are unable to secure NHS roles due to recruitment freezes and budgetary constraints.

In a 2025 consultation, the RCM found over 80% of midwives in England, Wales, and Northern Ireland expressed dissatisfaction with their working conditions, citing chronic understaffing, unsafe workloads, and an inability to provide adequate care as key concerns. These pressures contribute to burnout and attrition, further exacerbating the shortage.

Persistent understaffing also heightens the risk of maternity negligence, as midwives struggle to meet essential care standards.

Birth injury and maternity trauma

When maternity services are understaffed, the ability to provide reasonable care is compromised. Delays in recognising foetal distress, inadequate monitoring during labour, and missed opportunities for timely intervention can all lead to unnecessary pain, preventable birth injuries and even the loss of a baby.

The NHS Resolution Annual Report 24/25 (PDF) revealed that maternity-related negligence claims remain one of the highest areas of compensation payouts. In many cases, these claims stem from failures to meet the expected standard of care due to systemic issues, including staff shortages and poor clinical governance.

The patient experience

The NHS is recognised as one of the safest healthcare systems in the world in which to give birth, delivering safe outcomes for the majority of mothers and babies. However, for some expectant parents, the ongoing shortage of midwives can result in a compromise in care.

Reduced continuity, delayed assessments, and limited access to support during labour and postnatal recovery can leave patients feeling vulnerable and unheard, potentially leading to negligent maternity care.

Some women report being left alone during critical stages of labour or receiving rushed care due to staff being overstretched. These experiences can erode trust in maternity services and contribute to maternity trauma and injury.

A call for systemic reform

It’s widely recognised that improving safety in maternity care requires structural reforms, as well as individual accountability. This includes:

• Sustainable workforce planning to ensure midwives are recruited, retained, and supported.
• Investment in training and supervision to uphold clinical standards.
• Transparent incident reporting and learning to prevent repeat errors.

Together, these reforms strengthen the system’s capacity to deliver safe, high-quality maternity care.

Upholding reasonable care in challenging conditions

The legal test for negligence looks at whether the care given would be considered acceptable by a responsible group of medical professionals with the right expertise. This means that if the care provided did not meet the standards accepted by other qualified professionals, and harm occurred as a result, it may be considered medical negligence.

Systemic pressures such as staffing shortages and resource constraints can make it difficult for even skilled and committed professionals to consistently meet this benchmark and it’s important to distinguish between individual fault and institutional failure.

However, regardless of the underlying cause, for families affected by birth injuries the consequences are deeply personal and often devastating.

If you’ve been affected by a birth injury or maternity negligence, or you feel your care fell short, seeking advice can help you understand your rights and next steps.