Women in England are at their highest risk of suffering a serious injury while giving birth since records began in 2020, NHS figures show.
The rate of women sustaining the most serious type of tear during childbirth rose to 31.1 in every 1,000 in January, February and March – the highest since monitoring began in 2020.
Similarly, the rate of women having a postpartum haemorrhage increased during 2025 to 31.2 in every 1,000 births – the highest annual rate over the five years data has been collected.
Helen Morgan, the Liberal Democrat health spokesperson, who obtained the figures from NHS England, said: “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.
“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.”
NHS bosses and ministers prepare for the publication on Tuesday of Lady Amos’s government-commissioned report into the state of childbirth care. It will add to the increasingly urgent clamour for a major transformation of often-inadequate childbirth care in order to make it safe.
There is growing speculation that Donna Ockenden – the senior midwife and childbirth safety expert who last week published a damning report into the NHS’s biggest ever maternity scandal, at Nottingham university hospitals NHS trust – will be appointed as the first maternity commissioner, with a remit to oversee much-needed improvements in the quality and safety of care provided.
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 intensifying for it to spell out its plans sooner.
The rate of third- and fourth-degree perineal tears has risen to 31.1 in 1,000, from 25 in 1,000 when figures were first published in June 2020. The rate of postpartum haemorrhage – which involves the loss of one and a half litres of blood – has increased similarly over that time, from 25.6 in 1,000 to last year’s 31.65 in 1,000. It was slightly lower – 31.2 in 1,000 – in early 2026.
The Department of Health and Social Care voiced unease at 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.
It decided last week to expand Martha’s rule to every maternity and neonatal unit in England, giving women and parents the right to a second opinion about the care of a mother or baby.
“The recorded rise in tears is potentially worrying”, said Dr Kim Thomas, the chief executive of the Birth Trauma Association.
Thomas said this could be the result of better diagnosis, as the NHS has been introducing a “care bundle” advising hospitals to diagnose and treat such injuries more quickly. The fact that older mothers and Asian women were more prone to tears, as well as the NHS’s unusually common use of forceps to deliver babies, could also mean more injuries were occurring, she added.
“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,” said Thomas.
Maternity experts also voiced concern after the Guardian found that the NHS in England was not properly recording the details of all births.
The outcomes of more than 85,000 of the 542,235 births that occurred during 2024-25 – 14.8% – were missing from the NHS’s Hospital Episodes Statistics dataset. So, too, were the outcomes of more than 100,000 of the 545,149 births during 2023-24.
The missing details include the place of delivery, method of delivery, babies’ birth weights, anaesthetics used, and how many weeks gestation the baby had reached.
Some NHS trusts are also not reporting all birth records to the separate Maternity Services Dataset.
“Incomplete data is a fundamental barrier to improving maternity care,” said Clare Livingstone, head of professional policy and practice at the Royal College of Midwives.
“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.”
