By Louise Harkin, Solicitor
When something goes wrong during pregnancy or childbirth, it can leave parents with serious questions about the care they received and whether anything could have been done differently.
Recent reports into maternity services in both Northern Ireland and the Republic of Ireland have examined these issues. While they highlight improvements in some areas, they also suggest that certain problems continue to arise, particularly delays in treatment, difficulties with monitoring during labour and issues with communication.
What did the State Claims Agency review find?
A key report in this area is the State Claims Agency ("SCA") review of catastrophic birth injury claims in Ireland, published in 2023.
The review examined 80 claims involving serious injury to babies and identified a number of recurring issues during labour. These included:
- In approximately 77% of cases there was evidence of delay in delivery
- Failure to correctly interpret CTG in more than 60% of cases
- Inadequate monitoring of fetal heart rate in over half of cases
- The review also identified inappropriate or incorrect use of oxytocin in a number of cases
These findings suggest that many serious birth injury claims reviewed by the SCA involved issues arising during labour, particularly difficulties in monitoring fetal wellbeing and responding to emerging concerns.
Northern Ireland: the 2024 independent review
An independent review of maternity services in Northern Ireland, led by Professor Mary Renfrew and published in October 2024, also identified concerns regarding the safety and quality of care.
The review found:
- Serious weaknesses in maternity services, alongside areas of good practice
- Pressures arising from staffing shortages and limited resources
- The need for system-wide reform and improved governance to ensure safe and consistent care
The report emphasised that improvements in maternity care require not only clinical improvements, but also better organisation of services, improved communication and stronger systems of oversight and accountability.
CTG monitoring and escalation
One of the key themes identified across these reports is the importance of monitoring during labour, particularly through the use of CTG.
Cardiotocography, often referred to as "CTG", is a test used during labour to monitor a baby's heart rate and the mother's contractions. It helps doctors and midwives assess how well the baby is coping during labour.
Changes in the baby's heart rate can sometimes indicate that the baby may be in distress. Where this happens, it is important that healthcare professionals recognise the signs and act promptly, for example by closely monitoring the situation or proceeding to delivery if necessary.
For this reason, correctly interpreting CTG recordings and responding appropriately is a key part of safe maternity care and is frequently considered in medical negligence cases involving birth injuries.
Recent safety reviews have highlighted:
- Delays in responding to abnormal CTG recordings
- Challenges in recognising and escalating concerns during labour
In some cases, these issues may lead to serious complications where a baby's wellbeing is not identified or acted on in a timely manner. They are also consistent with the findings of the SCA review, which identified monitoring and response during labour as key factors in a number of claims.
What does this mean for patients and families?
It is important to emphasise that many women receive safe and appropriate maternity care, and not all complications during pregnancy or labour are the result of negligence.
However, where care falls below an acceptable standard and this leads to injury, it may give rise to a clinical negligence claim.
Examples of issues which may arise in this context include:
- Failure to properly monitor labour
- Misinterpretation of CTG results
- Delay in performing a necessary caesarean section
Each case depends on its own facts and must be assessed by reference to the care provided and the outcome for the patient.
What should I do if I have concerns?
If you are concerned about the care you or your child received during pregnancy, labour or the postnatal period, you may wish to:
- Request copies of your medical records
- Make a note of your recollection of events
- Seek medical advice if required
If concerns remain, it may be appropriate to seek legal advice from a solicitor.
How can we help?
We understand that concerns about maternity care can be distressing, particularly where a child may have suffered injury.
Our team has experience dealing with complex medical negligence claims across Ireland and Northern Ireland, including cases involving birth injuries, delays in delivery and failures in monitoring during labour. In a recent case, we secured €185,000 for a mother injured by negligent care during labour.
We aim to provide clear, practical advice and to guide clients through what can be a complex and sensitive process. Find out more about our birth injury claims.
Disclaimer
The content of this article is provided for information purposes only and does not constitute legal or medical advice. This article reflects our interpretation of the findings contained in the reports referred to above. Readers should consult the original publications directly if they require detailed information about the reviews or their conclusions.
