Women in England are at their highest risk of suffering a serious injury while giving birth since records began in 2020, according to NHS figures. The rate of women sustaining the most serious type of perineal tear rose to 31.1 in every 1,000 births in the first quarter of 2025, the highest level since monitoring started. Similarly, the rate of postpartum haemorrhage increased to 31.2 per 1,000 births in 2025, marking the highest annual rate over the five years data has been collected.
Political and Expert Reactions
Helen Morgan, the Liberal Democrat health spokesperson, who obtained the figures from NHS England, described the trend as a national crisis. “Behind these statistics are women going through unimaginable trauma, requiring surgery and in many cases months or even years of recovery. Some will never fully recover,” she said. “This news … shows that we need to treat maternity services as a national crisis. The truth is that we will not reverse this dangerous, unacceptable trend – of rising blood loss and record severe tears – until we make safety a priority.”
The Department of Health and Social Care expressed concern over the birth injury trends. “These are concerning findings, and as last week’s shocking report into maternity services at Nottingham university hospitals [trust] underlined, too many women are being failed by poor quality maternity care,” a spokesperson said. The department recently expanded Martha’s rule to every maternity and neonatal unit in England, granting women and parents the right to a second opinion regarding care.
Upcoming Reports and Potential Reforms
NHS bosses and ministers are preparing for the publication of Lady Amos’s government-commissioned report into the state of childbirth care, which will add to calls for a major transformation of often-inadequate services. There is growing speculation that Donna Ockenden, the senior midwife and childbirth safety expert who published a damning report on the Nottingham maternity scandal, will be appointed as the first maternity commissioner to oversee improvements. Ockenden is already investigating two other emerging childbirth scandals in Leeds and Sussex.
The government intends to publish an action plan to transform maternity services by the end of the year, but pressure is mounting for earlier clarity.
Data Trends and Missing Records
The rate of third- and fourth-degree perineal tears has risen from 25 per 1,000 in June 2020 to 31.1 per 1,000 in early 2025. Postpartum haemorrhage rates increased from 25.6 per 1,000 in 2020 to 31.65 per 1,000 in 2024, before slightly declining to 31.2 per 1,000 in early 2025.
Dr Kim Thomas, chief executive of the Birth Trauma Association, noted the rise in tears could be due to better diagnosis, as the NHS has introduced a care bundle advising hospitals to diagnose and treat such injuries more quickly. She added that older mothers and Asian women are more prone to tears, and the NHS’s frequent use of forceps may also contribute to injuries. “I don’t necessarily think that the apparent increase in third- and fourth-degree tears is a sign of worsening maternity services, though it may be,” Thomas said.
Data Gaps Hinder Improvement
The Guardian found that the NHS in England is not properly recording details of all births. Outcomes for over 85,000 of 542,235 births in 2024-25 (14.8%) were missing from the Hospital Episodes Statistics dataset, as were outcomes for over 100,000 of 545,149 births in 2023-24. Missing details include place of delivery, method, birth weights, anaesthetics, and gestation weeks. Some trusts also fail to report all birth records to the Maternity Services Dataset.
Clare Livingstone, head of professional policy and practice at the Royal College of Midwives, said, “Incomplete data is a fundamental barrier to improving maternity care. Without a full picture of what is happening before, during and after birth, it is much harder to identify where action is needed and these figures point to a significant gap in NHS maternity data.”
