Women should not feel pressurised into experiencing an “ideal birth”, the new health secretary, Yvette Cooper, has said, promising a root-and-branch reform of standards after several damning maternity scandals.
Cooper, who returns to the department ۲۷ years after she was the minister for public health under Tony Blair, said maternity and child health would be a major focus in the role, where she will also be expected to implement significant reforms to social care.
In an interview with the Guardian, she said the culture change should address any pressure on women to have a particular kind of birth experience, after families have repeatedly raised the alarm about an unwillingness by some maternity units to escalate interventions because of a desire for more natural births.
“I would worry about any mum feeling pressurised that there is somehow a kind of an ideal birth experience to live up to when it’s always different in every case, and you have to follow the evidence, you have to have informed choice,” she said.
In one of her first acts as health secretary, Cooper said she intended to re-introduce binding national maternity standards, which were dismantled under the early Conservative NHS reforms and replaced with fragmented trust-by-trust practices.
The standards, to be drafted by a new maternity taskforce, would have five key aims. They include ending the postcode lottery for levels of care, and tackling racial inequalities that have meant worse outcomes for deprived areas, in particular for black and Asian women. They will also make patient experience part of the measurement of standards and have targets that will give early warning of underperformance before a major scandal develops.
Cooper, who was the first minister to take maternity leave, as a junior health minister in the early ۲۰۰۰s, said she had found the reports of maternity scandals “traumatic” to read and that it was clear systemic change was needed.
“We’ve always said the NHS is about the cradle to the grave. I want to make it a personal crusade to put the cradle back at the heart of the NHS, and to have much more focus around maternity and child health, the very beginning of a family’s life, making that much more central to the priorities of the NHS, giving it the priority that it really deserves.”
Cooper said that there had been discussions for the past two decades about how maternity services could better listen to mothers’ needs. But she said on returning to the department, it felt clear that emphasis had been lost.
“It feels incomprehensible that we could be in this situation in the ۲۰۲۰s. I went back to look at some of the things that we’d done ۲۵ years ago. And what did strike me was how much we were talking then about women and families being at the centre of care and about listening to women’s views.
“It is really shocking and distressing feeling that has somehow been lost in some of the maternity units where actually it should be the central issue. I had a direct interest. I was pregnant at the time. But I am really struck by it now, just feeling like there is this big gap in the priorities that the NHS has been focused on,” she said.
Cooper added she was determined to provide a robust response to the two major independent inquiries into maternity failings – Donna Ockenden’s reports into major trust-level failures in Shrewsbury and Telford and at Nottingham, alongside Valerie Amos’s national investigation into England’s maternity system.
Both highlighted systemic clinical errors, understaffing and toxic institutional cultures, revealing that hundreds of infant and maternal deaths were directly attributable to a refusal to listen to mothers and a defensive impulse toward institutional cover-ups.
Amos’s review, in particular, has faced significant backlash including the resignation of one expert adviser over the lack of explicit warnings about “normal birth ideology” – and over Amos’s central recommendation for a new statutory maternity commissioner, which families said would lack meaningful independence.
Cooper said she was committed to introducing a commissioner. “In the end, the most important people in the maternity services are the mothers, babies, the families. But the point of having a maternity commissioner is to make sure that those issues are championed as part of an NHS,” she said.
She said she was clear about the need to tackle an oppositional culture in some trusts between doctors and midwives – and how they approached levels of intervention in birth.
“The thing that struck me most was the sense of women feeling they weren’t being listened to … And I think that probably does go back to issues around culture,” she said.
Cooper, until recently foreign secretary, said she was prepared for a tough fight in the health role as she sought to implement Andy Burnham’s social care reforms – saying she was committed to putting in place a national care service, announced by the prime minister last week.
A longstanding ally of the former prime minister, Keir Starmer, and a former leadership rival of Burnham’s in ۲۰۱۵, Cooper said she believed the change of prime minister had been necessary.
“Of course it’s not easy. I really did not think it was possible to win the election when I came back into the shadow cabinet in ۲۰۲۲. It’s only because of what Keir did that we managed to win.
“But we had very difficult local election results … we have to respond to that. But I think we’ve got a sense of energy now.
“All of the things that Andy wants to focus on and drive are also just very much the things that that people are concerned about across the country.”
