Failings
How families have been failed
More than 350 families have come forward and their experiences highlight recurring patterns of failures. Below are the more common issues experienced:
A mother's experience
"They took our daughter's entire life away and completely destroyed me and my partner when they could have easily prevented her death.”
Deaths of babies
We believe that the deaths of babies have been caused by repeated mistakes, a failure to listen to women’s valid concerns, and a lack of personalised care.
Families have shared key factors they believe have caused these devastating losses – the failure to follow national guidelines, dangerously late induction timings, and unsafe systems. Women who questioned their care have often been treated disrespectfully, while newly qualified staff were allowed to act without adequate supervision.
It appears that a consistent inability to recognise or act on risks has directly contributed to these deaths. The impact on families who have lost babies is immeasurable. These deaths have destroyed lives, shattered careers, and left parents and families struggling with overwhelming grief.
For those who lose a child, the devastation is indescribable – an entire life, full of potential, has been taken away. The long-lasting impact on families, who must live with the consequences of these failures, emphasises the urgent need for accountability, reform and compassionate care.
A mother's experience
"My son’s brain injury means that he requires 24/7 care as he is unable to meet any of his own needs. He is tube fed, non-verbal, non-mobile, and visually impaired. I have had to step-back from my career of 20 years to care for him which has put a big financial strain on us as a family. Our own physical and mental wellbeing as parents is also impacted as the physical demands of his care fall to us alone as there is very little support from services in the community. Our other primary school aged child is getting counselling at school as he has anxiety caused by witnessing his brother being rushed to hospital on multiple occasions. The harm our son experienced has had devastating consequences for all of us who love him."
Babies harmed at birth
Harm to babies under OUH’s care has had devastating and lifelong consequences for families. Babies have suffered serious injuries, including brain damage, hypoxic-ischemic encephalopathy (HIE) and cerebral palsy.
These injuries not only cause lifelong physical and cognitive disabilities for the children harmed but they also have a profound impact on their families.
Parents are often forced to sacrifice careers and salaries to provide the round the clock care and support their children need, while siblings also become caregivers a role that significantly alters their own lives.
The consequences of harm require support and services from the local authority and community health teams, putting further strain on already overstretched resources.
Families involved in the campaign believe the reasons behind this harm are rooted in systemic failures in OUH Maternity Services, including a reluctance to intervene in high-risk situations, a failure to listen to women’s concerns, and delays in taking action when risks are identified.
From listening to families, these issues are compounded by a failure to follow national guidelines, insufficient staff training, and a culture that ignores and dismisses the needs and voices of patients.
The long-term effects on these families cannot be overstated, as they are forced to navigate a lifetime of medical, emotional, and financial turmoil.
A mother's experience
"I felt that the safest way for me to give birth was via an elective caesarean. It became apparent that this was not something that would be facilitated there...The psychological harm that was caused negotiating this ‘system,’ lead to a lack of bond with my baby and was the most horrific experience of my life."
Denying caesareans
Oxford University Hospitals maternity services’ harmful ban on maternal-request caesareans which spanned more than four years was driven by a push to lower caesarean rates and promote 'normal birth'. This policy caused significant psychological harm to women, putting them through invasive psychological assessments and pressuring them into vaginal births.
Women whose requests for caesareans were approved were forced to travel long distances, sometimes to Gloucester, Swindon, and even Greater Manchester, to give birth by caesarean.
At this time, OUH operated a two-tier system where NHS patients were denied caesarean births, while the same obstetricians offered private caesareans at the John Radcliffe Hospital, creating a clear inequality in care.
We have strong concerns that the anti-caesarean and pro-normal-birth attitude remains within OUH Maternity Services and women still report difficulties accessing caesarean births.
A mother's experience
"After a forceps birth I was left with damage that I have had to pay privately for to be repaired. I feel completely failed by the midwives and obstetricians who didn't fully inform me of the risks."
Physical harm to women
The use of forceps in OUH Maternity Services, which could be driven by a desire to avoid caesareans, has caused significant physical harm to women in the campaign group.
The use of forceps has often resulted in traumatic, high-risk deliveries, leading to severe injuries such as vaginal tears, pelvic organ damage and long-term physical complications. Women have been subjected to unnecessary procedures without full consideration of their health and wellbeing, putting them at risk of lasting pain and disability.
We believe that this disregard for safer, more appropriate birthing options has contributed to physical harm and a lack of adequate information about the risks of assisted birth has undermined informed consent practices.
Inadequate postnatal care
A mother's experience
“A midwife cut my underwear off with scissors, leaving me uncovered and bleeding on the bedding in front of my birth partner... I felt like a piece of meat in a pool of blood with no shred of dignity left.”
A mothers's experience
"Their failures destroyed me. A board discussion confirmed they believed my care and failures led to my mental health breakdown. Eight months on I’m still on anti-psychotics, seeking help once a week. I’m still hearing voices and hallucinating, all because of their negligence."
Psychological harm
The psychological harm experienced by members of the campaign group has been severe, with women sharing their experiences of being lied to, gaslit and blamed for their own mistakes when things went wrong.
The care provided was often callous and misogynistic, marked by a lack of compassion and empathy.
This disregard for women’s wellbeing has led to long-lasting mental health difficulties, including postnatal depression (PND), post-traumatic stress disorder (PTSD), and anxiety.
The absence of trauma-informed care only worsened the impact; leaving many women to struggle with the aftermath of their experiences.
A mother's experience
"I had a very traumatic birthing experience at the John Radcliffe which included PROM (baby was delivered +72 hours after my waters broke as the delivery suite was at full capacity), cervix check with fingers before delivery, forceps, distended bladder and indwelling catheter for 7 days...this resulted in a postpartum lochia infection which was not treated with empathy."
Delays in taking action
We believe that Oxford University Hospitals maternity services have demonstrated a reluctance to take timely action and intervene when necessary.
In these cases, women have faced significant trauma, including delays in delivery due to reaching full capacity on the delivery suite, with no immediate care to address the risks of prolonged rupture of membranes (PROM).
A lack of timely intervention has led to unnecessary risk and procedures, putting mothers and babies at risk of harm. A failure to intervene appropriately, combined with a lack of empathy, has caused lasting consequences for women’s health and wellbeing.
A mother's experience
"I asked the doctor if my blood-thinning injections should be extended...he asked where I’d got that from while smirking at me, so I replied it was national guidance and he said it wasn’t necessary. Fast forward a week and I’m in an ambulance back to the John Radcliffe Hospital. I had a pulmonary embolism and if I hadn’t gone back the outcome could have been so different."
Failure to listen to women
Women in the campaign group report repeat failures to listen when they express concerns about their bodies and their babies, during pregnancy and in labour.
Many women in the campaign have shared experiences of being ignored when reporting pain, warning signs, or clear symptoms of complications. Some have been told their waters hadn’t broken- dismissed as simply wetting themselves and sent home - only to later suffer serious consequences.
Others have had their pain downplayed, leading to delays in necessary care. We believe that this failure to listen to women is rooted in misogyny and has resulted in missed risks, unnecessary suffering, and avoidable harm.
A mother's experience
"Our daughter was born with breathing difficulties and was grey. She was rushed away to be treated without me seeing her, and the aftercare around this was appalling. I was told I wouldn’t be able to see her unless I walked to her."
Inhumane care during childbirth
Women have described their experiences of the care they received as inhumane. Staff were often rude, cold, and judgmental, showing no regard for their emotional or psychological needs.
There appears to be a serious lack of understanding of the safe, respectful and compassionate care needed to support women’s mental wellbeing. Midwives and nurses are said to have failed to demonstrate empathy or offer the necessary time and attention to women in their care. This left many women feeling like an inconvenience rather than a person deserving person-centred care.
The impact on maternal mental health has been devastating, with many women left feeling dismissed, unsupported, and traumatised. It has contributed to lasting issues such as anxiety, depression and a deep sense of disempowerment.
A mother's experience
"A midwife cut my underwear off with scissors, leaving me uncovered and bleeding on the bedding in front of my birth partner. She said she would bring more underwear but she did not return. At this point I was in tears as I felt like a piece of meat in a pool of blood with no shred of dignity left."
Unacceptable postnatal care
The postnatal care provided to families in the campaign has been shockingly inadequate. Women have often been treated inhumanely and left feeling like pieces of meat on the postnatal ward.
Errors in pain-relief monitoring and a failure to provide appropriate pain management has resulted in women suffering unnecessarily, often left in severe discomfort without timely assistance. In some cases, women have been left lying in their own blood, unattended, and without the care they needed to recover.
This lack of basic compassion and attention extended beyond pain relief, with inadequate monitoring of physical recovery, a lack of support for breastfeeding and insufficient emotional care. Many women felt isolated, neglected and dehumanised during their most vulnerable moments.
The impact of this unacceptable care has led to physical complications, psychological trauma and lasting emotional harm, including feelings of worthlessness and anxiety.
This failure to provide high-quality postnatal care has left many women struggling long after their birth experience, with lasting effects on their mental health and overall wellbeing.
A mother's experience
"Heartbreakingly my son wasn't destined for this world and was a late term miscarriage at 23 weeks. Surgery was horrendous, I was left on a delivery suite with babies crying. Failure of referrals on mental health took 23 hours. I saw a mental health team on the ward by which point I was on the verge of psychosis, hearing voices and hallucinating."
Inadequate perinatal mental health
We believe that OUH Maternity Services consistently fail to provide adequate perinatal mental health care. Many women and families have been left without the essential support they need during their most vulnerable moments.
Families who have experienced the heartbreaking loss of a baby are left without access to perinatal mental health services. The lack of support for grieving parents has been compounded by poor crisis care.
Families have often been forced to turn to charity lines for support, as the NHS system failed to provide the comprehensive care and resources they desperately need.
This lack of appropriate and timely mental health support has left many parents isolated, struggling with their grief, anxiety and trauma, without the professional care required for healing.
A mother's experience
"I felt like the MNVP were more on the side of the hospital than the severely harmed families."
Lack of independent feedback channels
From listening to the experiences shared in the campaign group, it appears that OUH maternity staff have repeatedly failed to learn from past mistakes, leading to ongoing harm for women and families.
When things go wrong, there is a troubling lack of honesty with families, leaving them in the dark and often unable to seek the support they need. The lack of opportunities to give independent feedback has prevented women from sharing their experiences and offering vital insight into areas where care is falling short.
Families’ experiences of using the Oxfordshire Maternity and Neonatal Voices Partnership (MNVP) feedback system have been ineffective; marginalising and dismissing women who wish to share their experiences of harm.
Mothers with lived experience have experienced being ignored when they have tried to contribute to, or join, the MNVP while ‘birthworkers’ and doulas who profit from birth are actively involved.
This potential conflict of interest, we believe, prevents Oxfordshire’s MNVP from accurately representing the voices of all birth experiences in the county and has contributed to systemic harm in maternity services.