Women in England are facing the highest recorded risk of sustaining serious birth injuries during childbirth since national monitoring began in 2020, according to newly released NHS data. The latest figures have intensified concerns over the quality and safety of maternity services, adding further pressure on the government and NHS leaders to accelerate reforms aimed at improving maternal healthcare across the country.
The data indicates that severe perineal tears and postpartum haemorrhage rates have reached their highest recorded levels, prompting renewed calls from healthcare professionals, patient advocates and policymakers for urgent action to address persistent shortcomings within England’s maternity system.
Severe Childbirth Injuries Reach Highest Recorded Levels
According to NHS England statistics, the rate of women experiencing third- and fourth-degree perineal tears—the most serious forms of childbirth-related injury—increased to 31.1 cases per 1,000 births during the first quarter of the year. This represents the highest level recorded since national monitoring of these injuries commenced in 2020.
These severe tears extend to the muscles surrounding the anal sphincter and, in some cases, the bowel lining. They often require immediate surgical intervention and may result in prolonged physical recovery, chronic pain, incontinence, and significant psychological distress for affected mothers.
The latest figures reveal a notable increase compared with the 25 cases per 1,000 births recorded when national reporting first began, highlighting a concerning upward trend over recent years.
Rising Cases of Postpartum Haemorrhage
The data also shows an increase in cases of postpartum haemorrhage, another potentially life-threatening childbirth complication. Defined as blood loss exceeding 1.5 litres following delivery, postpartum haemorrhage can require emergency medical treatment, blood transfusions and intensive monitoring.
During 2025, the annual rate climbed to approximately 31.65 cases per 1,000 births, while the figure for early 2026 remained similarly elevated at 31.2 per 1,000 births. This compares with 25.6 cases per 1,000 births when the NHS first began publishing comparable statistics five years earlier.
Medical experts note that although advances in emergency care have improved survival rates, postpartum haemorrhage remains one of the leading causes of maternal complications worldwide and demands rapid clinical intervention.
Growing Pressure for Maternity Reform
The release of the latest statistics comes amid mounting scrutiny of NHS maternity services following several high-profile investigations into patient safety failures across England.
Healthcare leaders are awaiting the publication of Lady Amos’s government-commissioned review into maternity care, which is expected to examine systemic weaknesses affecting childbirth services nationwide. The report is anticipated to recommend significant reforms aimed at improving patient safety, accountability and clinical standards.
Pressure has also intensified following the publication of Donna Ockenden’s independent review into maternity services at Nottingham University Hospitals NHS Trust. That investigation identified widespread failures that contributed to avoidable deaths and serious injuries involving mothers and babies over an extended period.
The findings have reinforced calls for a nationwide overhaul of maternity care to ensure similar failings are prevented across other NHS trusts.
Political Calls for Immediate Action
Helen Morgan, the Liberal Democrat health spokesperson, described the latest figures as deeply concerning, warning that they reflect the experiences of thousands of women enduring severe physical trauma during childbirth.
She argued that maternity services should now be treated as a national healthcare priority, stating that many women require extensive surgery and lengthy rehabilitation following serious birth injuries, while others continue to experience permanent complications.
Morgan stressed that improving patient safety must become the central objective of maternity reform if the upward trend in severe injuries is to be reversed.
Government Responds to Mounting Concerns
The Department of Health and Social Care acknowledged the seriousness of the findings, describing the data as concerning while recognising that recent investigations have exposed significant shortcomings within maternity services.
Officials reiterated the government’s commitment to improving maternity care and highlighted recent measures aimed at strengthening patient safety.
Among these initiatives is the nationwide expansion of Martha’s Rule, which will now be implemented across every maternity and neonatal unit in England. The policy allows expectant mothers and families to request an independent clinical review whenever they believe concerns about care are not being adequately addressed.
The government is also expected to publish a comprehensive maternity improvement strategy before the end of the year, outlining reforms designed to enhance clinical standards, strengthen oversight and improve patient outcomes.
Experts Offer Possible Explanations
While the rising figures have generated concern, maternity specialists caution that the increase may not necessarily indicate deteriorating standards of care alone.
Dr Kim Thomas, Chief Executive of the Birth Trauma Association, suggested that improved clinical awareness and diagnosis may partly explain the higher reported rates of severe perineal tears.
The NHS has introduced a specialised “care bundle” in recent years that encourages clinicians to identify and accurately record these injuries, potentially leading to more comprehensive reporting than in previous years.
Dr Thomas also noted that several demographic and clinical factors contribute to elevated risks. Older mothers and women of Asian ethnicity are statistically more likely to experience severe tears during childbirth. Additionally, the relatively frequent use of forceps-assisted deliveries within the NHS may also increase the likelihood of serious perineal injuries.
Although improved diagnosis may account for some of the increase, experts agree that continued monitoring remains essential to determine whether clinical outcomes are genuinely worsening.
Concerns Over Incomplete Maternity Data
Alongside rising injury rates, healthcare experts have expressed concern regarding significant gaps in NHS maternity data collection.
Recent analysis indicates that outcome information for more than 85,000 births during 2024–25 was missing from NHS Hospital Episodes Statistics. Similar reporting gaps affected over 100,000 births during the previous year.
The missing information includes important clinical details such as delivery methods, birth locations, birth weights, gestational age and anaesthetic use. Some NHS trusts have also failed to submit complete information to the national Maternity Services Dataset.
Healthcare organisations warn that incomplete reporting limits the NHS’s ability to identify trends, evaluate clinical performance and implement evidence-based improvements across maternity services.
Clare Livingstone, Head of Professional Policy and Practice at the Royal College of Midwives, stated that comprehensive data collection is fundamental to improving maternity care. Without accurate national information, identifying safety concerns and measuring the effectiveness of interventions becomes considerably more difficult.
Calls for Long-Term Improvements
The latest NHS figures have reinforced growing demands for sustained investment in maternity services, improved workforce training, stronger clinical governance and enhanced patient safety measures.
With several major reviews already highlighting systemic weaknesses across maternity care, healthcare leaders, professional organisations and patient advocacy groups argue that comprehensive reform is essential to restore public confidence and reduce preventable harm.
As investigations continue and new policy measures are introduced, the focus remains on ensuring safer childbirth experiences for mothers and babies while addressing longstanding structural challenges within England’s maternity services.