Evidence repeatedly shows that black, Asian and mixed ethnicity women are more likely to die, experience baby loss, become seriously unwell and have worse experiences of care during pregnancy and childbirth, compared to white women, in the UK. Birthrights charity is convening a national inquiry into racial injustice in maternity care. Solicitor Olivia Boschat, who is working to support Birthrights in their national inquiry, recommends some key steps women can take to safeguard their rights during their experience of pregnancy and childbirth:
"Your rights
Every person has the right to receive appropriate healthcare, whether privately or through the NHS. The right to safe maternity care is fundamental to the wellbeing of women, their children and their families.
Women have the right to equality, which means that they should be free from discrimination. Appallingly, this isn’t always the case. There is repeated evidence of racial inequality and injustice in maternity care in the NHS going back many years. There’s also a clear link between the number of women dying during and following pregnancy, and their racial background.
I hope to provide some practical advice so that women can know what their rights are, what steps to take to minimise risk of harm and what to do if things go wrong.
Making decisions
All patients have the right to be involved in decisions about their treatment and care. In order to be able to do this, patients have the right to know the risks of each procedure and the alternatives to it.
Medical professionals must support women to make informed decisions. Women have the right to be listened to, and to be given the information they need to make a decision. They must be given the time and support they need to understand the treatment, alternatives and consequences.
Medical professionals must, by law, gain informed consent before carrying out any form of medical treatment, unless the patient lacks the legal capacity to decide.
This means that if you don’t understand something, you should ask for it to be repeated. The doctors and nurses caring for you have to explain the treatment to you in a way that you understand and give you the time you need to consider the options. You’re not being a nuisance. You have a right to ask.
Practical steps to take
For many people, any form of hospital or doctor’s appointment can be nerve-wracking. When pregnant, women are more vulnerable and it can be overwhelming. Coronavirus has amplified the anxiety and stress involved with many women not being allowed to bring a partner or person to support them during antenatal or postnatal appointments.
I recommend anyone attending an appointment to jot down questions beforehand. There’s nothing more annoying than remembering a question when you walk out of the appointment room, and having unanswered questions can increase anxiety. Having a note of questions in advance can help jog your memory and make appointments less stressful.
A great tip is for you to take note during the appointment of key points the doctor or nurse has explained. If you don’t understand something, ask for it to be repeated. This is your medical care and you have a right to understand it.
Try to carry out some research online via organisations and charities to gain knowledge about pregnancy, what can happen and your options. The charity Birthrights has abundant advice and resources to equip women and families during and after pregnancy.
The organisation Five X More has identified Six Steps that pregnant women can take to help minimise harm.
What if something has gone wrong?
If you’re worried that something has gone wrong in your medical care, I strongly recommend you ask questions so that you can understand what has happened.
The first step I recommend is to request a copy of your medical records from the hospital you’re being treated at. Medical records should be kept for all patients having medical treatment. In a maternity setting, they will be completed by midwives and doctors. You’re entitled to see your medical records.
Each hospital in the NHS will have a medical records department and procedure for you to request your records. You may be asked for a signed form to access your records, but you shouldn’t have to pay for them. Getting your medical records may help you to piece together the medical treatment you received.
If you’re worried something has gone wrong, you may wish to make a written complaint letter to the hospital to ask questions. There’s no shame in doing this. Each hospital has a Patient and Liaison Service (PALS), and they can give you access to the hospital’s complaint procedure and help you to understand what has happened.
I would urge anyone who thinks something has gone wrong in their medical care to reach out and speak to charities for support and guidance. In particular, the charity Birthrights supports and campaigns for women and families during and after pregnancy. They have recently set up a national inquiry into racial injustice in maternity care.
This inquiry will investigate how racism in the NHS is adversely impacting mothers and babies, and maternity care as a whole. The aim is to determine exactly what needs to be done at all levels to effect change.
Legal claim for medical negligence
As a solicitor specialising in women’s health, I sadly see the impact of medical mistakes on individual women and families. I assist women who have suffered physical or emotional injuries as a result of substandard medical treatment. I also specialise in helping families when their child has been seriously injured during labour and birth. I help families to get justice when the negligence has caused death.
The aim of a medical negligence claim is to obtain compensation (money) from the opponent. In order to win a medical negligence claim, you have to prove that:
- The medical treatment provided was so poor that no other responsible body of medical practitioners would have provided it (this is called breach of duty); and
- This breach of duty caused a significant injury which should have been avoided had the treatment been legally acceptable (this is called causation).
A legal claim for medical negligence is not a route anyone really wants to pursue. Every client I’ve represented would much rather the negligence had not occurred. For many injured people, the damage has cost them not only physically and emotionally but also financially.
While money can very rarely compensate a person for the extent of the injury suffered, it can help with recovery, medical treatment and support for the future.
Olivia Boschat is an Associate Solicitor in the Women’s Health team at Bolt Burdon Kemp and can be found on twitter here @omitchisonbbk**
