Ana Megawati
Two days after giving birth, Juliana Nascimento Barbosa is still ecstatic about becoming a mother. “I’m so happy to have my baby,” she says from her bed in Queen’s hospital in Romford, Essex, smiling broadly. To her left, her husband, Emerson, sits on a chair, a pillar of support. To her right, their newborn son, Dominic, lies on a neonatal resuscitaire, bathed in the soft blue glow of phototherapy – a crucial light treatment designed to alleviate his neonatal jaundice. He is wearing a tiny nappy, his eyes shielded by a mask from the machine’s four bars of bright light, working diligently to purge his tiny body of bilirubin, the yellow pigment that causes jaundice, as his liver is not yet strong enough to process it independently. He cries softly when a nurse performs a heel prick test, collecting a few spots of blood to monitor his condition, a routine yet vital check in his early days.
Juliana’s radiant joy, however, belies a birth experience that, like many, proved complicated and underscored the increasing complexities faced by modern maternity services. Her continued stay in the hospital is not solely for Dominic’s care but also for her own recovery, a testament to the demanding nature of childbirth even with the most dedicated medical support.
A Mother’s Ordeal: Navigating Complications and Care
Juliana’s labour had begun, progressing slowly but steadily. The calm, however, was soon interrupted. A cardiotocograph (CTG) trace, meticulously monitoring her baby’s heartbeat, revealed a concerning development: Dominic had passed meconium – his first stool – while still in utero. Dr. Kathryn Tompsett, the head of maternity and children’s care at Queen’s Hospital, explains the gravity of such an event. “That can be a sign of a baby’s distress, perhaps because they have an infection or are not getting enough oxygen,” she clarifies. “When that happens, the priority is to get the baby born ASAP, usually within 30 minutes.”
This "safety-first" approach is a cornerstone of modern obstetric practice, where the well-being of two lives hangs in the balance. A delayed or incorrect decision can lead to devastating consequences, including brain damage for the baby, with potential costs to the NHS soaring to £20 million in damages per case, highlighting the immense stakes involved.
The medical team at Queen’s responded with swift efficiency. Juliana, by then, had fortunately become fully dilated, aiding the rapid progression. Fifteen hours after her labour commenced, and six hours after staff manually ruptured her membranes to accelerate the process, Dominic was born. His delivery was vaginal, but it was an assisted birth, requiring the skilled intervention of Dr. Georgina Lennon-Butler, a resident obstetrician. She employed a ventouse suction cap to help guide him out and performed an episiotomy, a small incision to create more space, facilitating a safer passage. Dominic’s birth, therefore, exemplifies the increasing reliance on medical intervention in maternity care, a reflection of childbirth becoming more complex and, at times, more perilous for both mother and child.
The Human Touch: Language, Empathy, and Mental Health
Amidst the medical procedures and clinical decisions, Juliana found profound comfort and crucial support in the human element of her care. She attributes much of her positive experience to two specific staff members who provided vital support during her daunting recent days and months. Using Emerson to translate her native Portuguese, she explains, “I had one problem – I have depression.”
Mariane, a psychotherapist embedded within the hospital’s maternal mental health team, and Yassi, a midwife who played a key role in Dominic’s delivery, became indispensable. Both spoke Portuguese, their linguistic skills proving as critical as their clinical expertise. Their ability to communicate directly in Juliana’s mother tongue helped her navigate the often-overwhelming process of labour and birth, transforming a potentially isolating experience into one of reassurance and safety.
“Mariane’s my doctor for my head. I’ve seen her throughout my pregnancy. She’s been caring for my mental health. It was comforting to have her around at the birth. It made me feel safe,” Juliana shares, underscoring the invaluable continuity of mental health support. Similarly, she expressed gratitude for Yassi: “Having Yassi there too made me feel more comfortable. She was my translator. She took care of me. It was very important for me to have her there.”
Reflecting on her overall birth experience, Juliana turned to Google Translate on her phone, tapping out a message that eloquently captured her sentiments: “Everyone played a very important role in our baby’s life. They were wonderful, very caring, and they made me feel safe, very safe. Labour is difficult for a woman and having such wonderful professionals as the team at Queen’s made us very happy.” Her words paint a vivid picture of the profound impact that compassionate, culturally sensitive, and skilled care can have, especially in moments of vulnerability.
A Troubled Past: Queen’s Hospital and the National Maternity Crisis
Juliana and Dominic received exemplary care at Queen’s, a bustling unit where approximately 7,000 babies are born annually. However, this level of care was not always the norm. For years, the hospital’s maternity service was plagued by substandard, and at times dangerously poor, care, leading to tragic outcomes, including infant deaths. This troubled history at Queen’s mirrors a broader, alarming crisis within NHS maternity services across England.
In 2021, the Care Quality Commission (CQC), the independent regulator of health and social care in England, rated Queen’s maternity service as "requires improvement." This assessment was reiterated after a subsequent inspection in early 2024, highlighting persistent concerns. Disturbingly, Queen’s was far from an isolated case; in 2023, the CQC reported that nearly two-thirds of England’s maternity units were deemed "unsafe," a stark indictment of systemic failures.
Queen’s Hospital, operated by Barking, Havering and Redbridge NHS Trust (BHR), is England’s third-largest single-site maternity unit. It was one of twelve trusts selected for investigation by Lady Amos as part of her government-commissioned, England-wide review of maternity and neonatal services, initiated in 2025. These trusts were chosen due to a recurring pattern of failings: "women’s voices ignored, safety concerns overlooked and poor leadership creating toxic cultures." Lady Amos’s highly anticipated report, set to be published on Tuesday, June 30, 2026, is expected to add to a growing body of official inquiries diagnosing widespread problems in NHS maternity care. This follows closely on the heels of Donna Ockenden’s scathing review in June 2026, which exposed horrific care failings at Nottingham NHS Trust between 2012 and 2025, prompting renewed calls for a public inquiry into broader systemic issues.
These reports consistently highlight critical areas for improvement: staffing shortages, inadequate training, poor communication, insufficient resources, and a culture that sometimes fails to prioritize patient safety and listen to mothers’ concerns. The government is expected to publish a comprehensive maternity action plan before the end of 2026, aiming to address these deeply entrenched issues.
Turning the Tide: Queen’s Hospital’s Journey of Transformation
Despite its challenging past, Queen’s Hospital has embarked on a remarkable journey of transformation. Following its "requires improvement" rating in 2021, a concerted effort to overhaul its maternity service culminated in the CQC declaring the unit "good" after its latest inspection in August 2025. This significant turnaround offers a glimmer of hope amidst the national gloom surrounding maternity care.
Matthew Trainer, the former chief executive of BHR NHS Trust, who recently departed, expressed confidence in the progress, stating that the trust had "turned the corner on a once troubled past in our maternity service." Wes Streeting, the local MP and former health secretary, echoed this sentiment, noting the service had improved "in leaps and bounds" and calling its progress "a huge achievement."
The catalyst for this transformation, as Dr. Tompsett explains, was a multi-faceted approach implemented since the 2021 rating. Key to this was a substantial investment in human resources. The maternity department’s staff headcount surged by 147, rising from 552 to 699. This increase included 22 more doctors, 14 of whom are consultants, and an additional 65 midwives. The unit now boasts its highest ever number of midwives, dramatically reducing its vacancy rate from a concerning 16% to a much healthier 4%.
Dr. Tompsett, an obstetrician with 18 years of experience, attests to the tangible impact of these changes: "I’ve seen huge improvement." The increased staffing has directly addressed a core problem identified by the CQC: the excessive delays expectant mothers faced in the triage area, the maternity equivalent of an Accident & Emergency department. The unit now "more consistently" triages women within the expected 15-minute timeframe for all arrivals, a crucial improvement for early assessment and intervention.
Further operational enhancements include the introduction of "flow coordinators" in 2024, who are on duty around the clock across the maternity service. Their role is to mitigate hold-ups as mothers-to-be move between different departments, ensuring smoother, more efficient patient journeys. Additional personnel have also been deployed to support the obstetric operating theatres, which are busier than ever. This increased activity reflects a national trend, with the proportion of babies delivered by caesarean section reaching 45% both nationally and at Queen’s, indicating a rise in medically necessary interventions.
Embracing Diversity: Tailored Care for a Diverse Community
A significant factor in Queen’s Hospital’s improvement has been its proactive and determined efforts to ensure that women without English as a first language receive a high standard of care. This focus is particularly critical given the demographic profile of BHR’s catchment area, which comprises multi-ethnic, often socioeconomically deprived communities. A staggering half of the 7,000 women who give birth at Queen’s annually do not speak English as their primary language, and 61% reside in the top 20% most deprived neighbourhoods in England.
To bridge these communication and cultural gaps, BHR has established a bilingual maternity support service, powered by dedicated volunteers like Saba Asif and Jobaida Alam, who were born in India and Bangladesh, respectively. These volunteers, many of whom have themselves given birth at Queen’s, offer their time for free several hours a week. “I tell them to relax and that even if they don’t understand the language that it will be fine, because we have interpreters – that they will be in good hands, in safe hands,” says Asif, encapsulating the reassurance they provide. This service not only facilitates communication but also fosters a sense of trust and understanding, vital for vulnerable mothers.
Beyond language support, Queen’s has also achieved a remarkable reduction in stillbirths, which fell by 31% over the past year. Dr. Tompsett explains the innovative strategy behind this success: analysing data to create a "heatmap" of local postcodes exhibiting an unusually high number of stillbirths. These areas, identified as regions of high deprivation, then received "dedicated one-on-one enhanced continuity of care" from midwives throughout the mothers-to-be’s pregnancies. This targeted, personalized approach underscores the hospital’s commitment to addressing health inequalities and improving outcomes for all.
The Broader Implications: A Blueprint for National Change?
While acknowledging the substantial progress, Matthew Trainer, the former CEO, remains realistic about the ongoing journey. “These changes have led to more people saying they’ve had a good experience at Queen’s and to a fall in complaints,” he stated on the trust’s website following the CQC’s positive rating. “We have more to do and I know these improvements have come too late for those who have lost a child and those who experienced poor care. We still have more to do to ensure every mother and baby get the care they deserve.” His candid reflection underscores the deep scars left by past failings and the continuous effort required to rebuild trust and consistently deliver excellence.
Maternity care is arguably the NHS’s most significant area of failure, with headlines about poor care often leaving expectant mothers apprehensive about their own experiences. The ongoing overhaul at Queen’s Hospital, however, offers a compelling narrative of optimism – a clear demonstration that significant improvement is not only desperately needed but also entirely achievable.
The lessons learned at Queen’s could serve as a valuable blueprint for other struggling maternity units across the country. Investing in staff, streamlining operational flows, prioritizing mental health, and providing culturally and linguistically appropriate care are not merely aspirational goals but essential components of a robust and compassionate maternity service. The economic implications are also profound; by preventing adverse outcomes, the NHS can mitigate the immense financial burden of negligence claims, freeing up resources for further improvements.
As Lady Amos’s report looms and the government prepares its action plan, the experience of Queen’s Hospital provides a tangible example of how dedication, strategic investment, and a patient-centered approach can transform a once-troubled service into a beacon of hope, ensuring that more families like Juliana’s can celebrate the safe and joyful arrival of their newborns. The journey is far from over, but for the first time in many years, there is a clear path forward for England’s maternity care.
