Introducing the Avoiding Brain Injury in Childbirth programme
In this article, our authors look at the Avoiding Brain Injury in Childbirth programme launched in May 2025, assessing its implications for maternity safety and clinical negligence.
Earlier this month, the Government announced that the Avoiding Brain Injury in Childbirth programme (ABC), which is planned to help maternity staff rapidly respond to emergencies and protect mothers and babies from suffering avoidable brain injuries like cerebral palsy, will now be introduced nationally from September 2025.
The rollout comes after multiple maternity care scandals in recent years, which led the Care Quality Commission (CQC) in 2023 to identify that two-thirds of maternity units were providing substandard care [1].
The ABC forms part of the Government’s wider ambition to urgently improve maternity outcomes under its Plan for Change. It has been specifically designed and trialled to reduce the risks associated with two key components of avoidable brain damage:
- Recognising and responding to a baby who may be deteriorating during labour, and
- Managing obstetric emergencies more effectively, such as ‘impacted fetal head’ at caesarean birth, which is when a baby’s head becomes lodge in the pelvis.
It aims to create clear clinical practice standards with supporting resources and high quality training; the Government believes these reforms will ‘ensure all women receive safe, personalised and compassionate care [2]’.
A systematic failing in maternity care?
Numerous reports, particularly the Ockenden Review [3] and the Kirkup Report [4], identified recurring issues such as:
- Failure to escalate concerns appropriately,
- Poor communication and teamwork among staff,
- A culture of denial and deflection when addressing mistakes, and
- Inadequate response and compassion regarding patient concerns.
Any avoidable brain injury acquired during labour will have devastating consequences for babies and their families. When impacted fetal head occurs, it is immediately an emergency. These births are technically challenging, with significant and serious risks to all involved.
Until the ABC, there were no national guidelines or consensus on how to manage these births, which led to a lack of evidence-based training. Practice varied greatly between trusts and diminished confidence amongst professionals.
The government recognised that such births should be treated as a whole-team emergency that requires clear management algorithms and collaboration.
So what does the ‘ABC’ Mean?
The ABC has been in development since 2021. It has been uniquely designed with input from families who have experienced the trauma that ABC aims to prevent, alongside leading organisations such as the Royal College of Obstetricians and Gynaecologists.
It focuses on creating a cascade model in which specially selected individuals are trained to circulate the teaching effectively to their local teams. This is to enable the knowledge to be spread quickly and effectively to a large number of staff, communicating the clear objective of best care, which importantly includes:
- Communicating effectively and respectfully with the person in labour and their birth partner,
- Enhancing fetal heart rate monitoring and interpretation and equipping staff with the skills to identify a baby showing distress,
- Creating a single standardised approach for national guidance and risk factors,
- Encouraging communication and confidence between doctors, midwives, and maternity teams during high-pressure situations.
Nine NHS hospitals took part in a trial late last year that was ultimately perceived as a success.
What is the practical impact on Clinical Negligence?
For the period covering 2023/2024, 12.8% of all clinical negligence claims against the NHS related to pregnancy, childbirth, and postpartum period (i.e. Maternity) [5]. This number has been gradually increasing each year.
The total spent on settlement of all claims over the same period reached £2.8 billion [6], which is a record high. Of that figure, 56.7% accounted for claims related to Maternity [7].
This disproportionate financial impact highlights the impact of harm on the patients and families affected, and, particularly, the extensive underlying financial costs that arise from a brain injury including the need for lifelong care.
While it is hoped that the urgent reform spearheaded by the ABC will lead to a reduction in brain injuries during childbirth and therefore a reduction in claims needed, the Department of Health and Social Care has set aside £58.2 billion to cover the potential costs of clinical negligence events occurring before April 2024, in a clear acknowledgement that negligence has historically occurred and negligence claims will be ongoing from before that date.
When should you seek professional advice?
If you think or know you or your baby have suffered inadequate care, which has led to lasting damage to either of you, it may amount to medical negligence.
This will depend on the circumstances and whether the medical care you received was below a reasonable standard. The first step should always be to seek an opinion from a medical professional and consider getting advice from a clinical negligence solicitor. They can evaluate what happened and advise whether you have a claim.
If it is decided that you do have a case, your solicitor will be able to guide and assist you through the claims process and help you receive the right compensation for you.
At Thompson, Smith and Puxon, our team of clinical negligence solicitors have the knowledge and expertise needed to competently handle medical negligence cases involving pregnancy and childbirth.
Our solicitors can help you collect the evidence needed to make a claim, and represent you through the legal process. For more information, or to start your free case evaluation, contact us on 01255 221919.
[1] Care Quality Commission, Safety, Equity and Engagement in Maternity Services: Findings from the 2022 Survey of Women’s Experiences of Maternity Care (2023)
[2] Department of Health and Social Care, Government response to the House of Lords inquiry into preterm birth: reducing risks and improving lives (Policy Paper, 14 January 2025)
[3] Donna Ockenden, Final Report of the Ockenden Review: Findings, Conclusions and Essential Actions from the independent Review of Maternity Services at the Shrewsbury and Telford Hospital NHS Trust (Department of Health and Social Care, 30 March 2022)
[4] Bill Kirkup, Reading the Signals: Maternity and Neonatal Services in East Kent – The Report of the Independent Investigation (HC 681, 2022)
[5] NHS Resolution, Annual Report and Accounts 2023-2024 (HC 73, 2024)
[6] Ibid
[7] Ibid