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Exclusive: NHS maternity care failings exposed as no service achieves top safety rating

Exclusive: NHS maternity care failings exposed as no service achieves top safety rating

Exclusive MadeForMums analysis reveals NHS maternity safety ratings have failed to recover since the Covid-19 pandemic, with no service achieving regulator’s highest safety rating.

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Ruairidh Pritchard

Published: August 6, 2026 at 4:45 PM

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Not one of the 205 NHS maternity services in England with a published safety rating is currently rated Outstanding by the Care Quality Commission (CQC), exclusive MadeForMums analysis has found.

The analysis suggests maternity safety ratings have failed to recover after deteriorating sharply in inspections published from 2021 onwards.

The deterioration first became apparent during the Covid-19 pandemic, when the proportion of inspected maternity services rated Requires Improvement or Inadequate for safety rose steeply, and it has remained persistently high ever since.

MadeForMums' analysis found no sustained return to higher CQC safety ratings in the inspections published since.

What do CQC safety ratings mean?

The Care Quality Commission (CQC) is the independent regulator of health and social care services in England. It inspects NHS maternity services and rates them in several areas, including safety. Safety ratings are:

Outstanding: The service is performing exceptionally well
Good: The service is performing well and meeting expectations.
Requires Improvement: The service is not performing as well as it should and improvements are needed.
Inadequate: The service is performing badly and significant improvements are required.

MadeForMums' analysis found that no NHS maternity service in England is currently rated Outstanding for safety.

The findings form the first part of a year-long MadeForMums investigation into maternity care across the UK, drawing on more than 200 Freedom of Information requests to NHS trusts and health boards in England, Wales, Scotland and Northern Ireland, analysis of all 319 CQC maternity safety inspections published since 2014, and NHS records covering more than 2.7 million births.

The investigation comes as new research from the Birth Trauma Association highlights the lasting impact traumatic birth experiences can have on families, with 44% of women affected by birth trauma saying they decided not to have another child.

Many women described ongoing challenges with their mental health, relationships, careers and finances, with some still living with the consequences years after giving birth.

The Birth Trauma Association survey found many women experienced lasting emotional, financial and practical challenges following a traumatic birth.

Key findings included:

Many respondents saying they delayed returning to work, reduced their hours or changed jobs because of their experiences.
One woman wrote: "I left that hospital a shell of myself and, ten years on, I have never regained my confidence or professional self or identity."
Birth trauma often affected the whole family, with many respondents describing strained relationships, changes to work and ongoing caring responsibilities.
Almost half, 46%, said birth trauma had affected their relationship with wider family members, while many said partners had needed to take time away from work to support them and their baby.
Some women saying they became so fearful of healthcare settings after giving birth that they avoided attending medical appointments altogether.

One respondent told the association:

My fourth-degree tear didn't just leave me with a physical injury. It affected every part of my life, including my mental health, my confidence, my relationships, and even my ability to leave the house without fear.

Another respondent told the association:

The psychological impact of my birth has cost me more than I ever expected. I was left with PTSD, postnatal depression and anxiety, and it took away my confidence to even leave the house, let alone go back to work.

Several respondents also described living with ongoing physical injuries that continued to affect work, relationships and everyday family life.

One woman described living with "not wanting to leave the safe space of your own house, taking change of clothes in a bag when leaving the house, feeling humiliated, not being able to do some family activities, feeling insecure and less desirable, painful intercourse, unable to stand for long periods of time at work, or unable to squat or change position easily at work/home."

Dina Thachar, who previously spoke to MadeForMums about recovering from a fourth-degree tear, told us:

I experienced a fourth-degree tear and a birth injury that ended up in me having an ileostomy operation and being left with a stoma. My entire recovery took well over a year.

Kim Thomas, CEO of the Birth Trauma Association, said the findings reflect what the charity hears from families every day.

As a charity, we frequently hear from women that their traumatic birth experience has affected all areas of their lives, from their partner relationship to their ability to pursue their career. Yet the research in this area has been minimal.

Kim Thomas, CEO of the Birth Trauma Association

Thomas added: "Our survey shows that the birth trauma affects women's finances, their careers, their relationships and their physical and mental health.”

“It is time for the government to take the cost of birth trauma seriously, and to address the problems in maternity care that are leading to so many women experiencing long-term trauma as a result of their birth experience."

This article is the first in MadeForMums' year-long investigation into NHS maternity care. Throughout August, we'll reveal exclusive analysis of maternity safety ratings, birth interventions, birth injuries, mental health support and regional variations in care across the UK.

Authors

Ruairidh PritchardDigital Growth Lead

Ruairidh is the Digital Lead on MadeForMums. He works with a team of fantastically talented content creators and subject-matter experts on MadeForMums.