TAMBA and NCT Maternity Services Report Finds Serious Shortcomings in the Care Given To Multiple Births Across the UK

A November 2015 report issued by the Twins and Multiple Births Association (TAMBA) in conjunction with UK NCT Maternity Services has highlighted serious shortcomings in the care offered to mothers of multiple births in the UK.

The news comes despite the introduction of new guidelines by the National Institute for Health and Care Excellence (NICE) in 2011. Blackwater Law clinical negligence solicitors now question whether more parents of multiple-birth children could now be eligible for birth injury compensation.

Multiple births (multiples) account for around 3% of UK pregnancies, although this figure is on the rise due to the increased use of assisted conception methods including the likes of IVF. It is well understood that prospective mothers of multiple children must face heightened health challenges and risks of complication – what concerns prospective parents and clinical negligence solicitors alike is that the stillborn rate for multiples stands at 1.07%; more than double that of singletons. What’s more, according to the latest statistics available, neonatal death rates stand at 11.5 per every 1000 live multiple births, compared with just 2.4 for singletons, with infant death rates measured at 14.5 per 1000 as compared to just 3.4 for singletons. Whilst these figures undoubtedly have a devastating emotional effect on the families concerned, they also have a deeply detrimental effect on our National Health Service as a whole; multiple births account for around 10% of all stillborn maternity clinical negligence claims raised in England, costing the NHS around £72 million between 2005 and 2014. With so many multiple birth mothers pursuing birth injury compensation claims, NHS administrators and clinical negligence solicitors alike are forced to consider what could be going wrong in our healthcare systems; and the TAMBA and NCT Maternity Services Report provides some answers.

The 2011 guidelines introduced by NICE outlined a range of measures seeking to transform the care of mothers expecting twins or triplets, reduce the number of stillborn multiples and give healthcare providers clear direction and support based on scientific, medical evidence. Three of the key measures to be employed amount to the following:

  • Mothers expecting a multiple birth should have access to multidisciplinary care teams comprised of a skilled midwife, obstetrician and sonographer – all of whom have expert knowledge of multiple birth scenarios
  • Said mothers should also have access to advice on referrals relating to when and where foetal medicine specialists are required
  • Additional antenatal education should be provided to prospective parents to prepare them for the additional challenges of multiple births / childcare

TAMBA / NCT’s report however, highlights some worrying trends in relation to performance of NHS Trusts against these guidelines. Approximately one in three mothers examined in the sample of 1338 respondents (taken from across the UK) (sampled as part of the report) indicated that they did not have access to a specialist obstetrician, whilst only 20% had access to a specialist midwife and 28% to a specialist sonographer. Blackwater Law clinical negligence solicitors also note that in some regions these figures were even worse, with only 7.8% of East Midlands patients having access to a specialist midwife. All of this culminates in the fact that twins or triplets are still twice as likely to be stillborn than single babies, and around five times as likely to pass away in neonatal care.

The report found the NHS to be failing prospective mothers in other areas too. Pregnant women in the UK (with the exception of Northern Ireland due to abortion laws) are routinely offered testing for Down’s syndrome during weeks 10-14 of their pregnancy, with those identified as high-risk supposedly offered further diagnostic testing along with an explanation of the risks involved. TAMBA & the NCT’s study found that only 81.7% of respondents were in fact offered screening for Down’s syndrome, some of whom were only offered ultrasound testing due to concerns that blood testing could return false positives in instances of multiple pregnancies. Of those tested, only 52.1% identified as being at high risk stated that they had the options and implications of diagnostic testing subsequently explained to them; illustrating a substandard level of patient care and suggesting a lack of staff education on the issue.

Examiners also found shortcomings in the provisions for multiple parents struggling to feed their new-borns in the preferred manner. 29.6% of respondents encountered difficulties relating to a lack of breast-feeding support, pressures to supplement with formula, problems feeding premature babies and separation from one or more children. In addition, only 42.1% of multiple parents stated they had been given advice on safe sleeping procedures for their children (i.e. co-bedding), illustrating a further need for staff education in relation to this issue also.

All in all, the report indicates a 10% increase in compliance with crucial NICE multiple birth guidelines over the four year period from 58.8% in 2010 / 11, up to 64.9% in 2013 / 14 and ultimately to 69.1% in 2014 / 15. Whilst this is noted as a positive step, it’s important to understand that at the current rate it will take another 12 years for rates to reach full compliance, in the meantime many thousands of UK multiple birth parents will be exposed to unnecessary risks due to human error and birth mismanagement.

Jason Brady, clinical negligence solicitor at Blackwater Law, said:

“It is not acceptable that so few expectant multiple parents are offered the specialist support they need. Given the increased risks that mothers and their unborn children face, it is crucial these parents have access to medical professionals with the necessary experience and expertise in managing multiple births. More needs to be done to fast-track the improvements in performance against the NICE multiple birth guidelines at Trusts across the country. Failure to do so may lead to unnecessary deaths.”

Patient satisfaction levels among multiple birth parents remain woefully low; with 47.6% of obstetrician advice on baby care rated as “poor” or “very poor”, as well as 44.1% of all prenatal education provided to prospective parents of multiple babies. It’s now estimated that around a third of multiple birth parents are dissatisfied with most areas of the care they receive from the NHS; raising the prospect of a great many more pursuing birth injury compensation claims or litigation relating to substandard care in upcoming years.

Are you entitled to claim birth injury compensation?

If you or a family member feel you have been subject to substandard care as a parent of multiple children, or that your children have suffered as a result of birth mismanagement on the part of your medical professionals, you may be able to pursue a clinical negligence compensation claim and / or birth injury compensation.

Blackwater Law clinical negligence solicitors today by phoning 0800 083 5500. You will receive free initial advice. All accepted cases are on a no win, no fee basis.