National change for birth advice is six-day-old girl’s ‘legacy’

A couple whose six-day-old daughter’s death sparked national reform in maternity care for mothers say it will “change lives”.

Mabel Williams suffered fatal brain injuries after her mum, Becky Williams, had an undiagnosed uterine rupture during labour at Great Western Hospital, Swindon, in September 2023.

Mrs Williams chose a vaginal birth for Mabel, after having a C-section for a previous child, but was not warned by the hospital of the potentially life-threatening risks for both of them if her uterus ruptured, an inquest heard in August.

“If those words ‘it can be fatal’ had been said to me, I’d never have risked my daughter’s life. That simple truth could have saved Mabel,” Mrs Williams said.

In the inquest in August, the coroner ruled neglect contributed to Mabel’s death, and was preventable, and warned pregnant women are not being warned enough of the fatal risks of vaginal birth after C-section (VBAC).

The Royal College of Obstetricians and Gynaecologists said it is updating a VBAC information leaflet, which is used by hospital trusts in the UK, to include information on the risks of uterine rupture after the coroner said there was a “lack of clarity”.

Great Western Hospital NHS Foundation Trust, which runs the hospital, said it will provide better access to information for parents “to support them to make informed decisions about their birth choices”.

The coroner, Robert Sowersby, produced two prevention of future deaths reports in the September for the hospital and the Royal College to address their recommendations.

The Royal College said it has responded to Mr Sowersby and the trust, which has until 5 November to reply.

Since Mabel died on 10 September 2023 in Bristol Children’s Hospital, Mrs Williams said she has spoken to dozens of mums who have experienced similar cases and wants to make sure it “never happens again”.

“Mabel’s life was short, but her impact can be lasting,” she said.

Mrs Williams said she was anxious about giving birth to Mabel, and chose to have a VBAC because hospital staff said there was “low risk”.

We live every day knowing that Mabel should be here. We did everything we could to protect her,” she said.

“We asked the questions, I voiced my fears. But the truth was hidden in medical language that made it sound safe.

“We trusted the professionals.

But the information we were given was incomplete, and the warning signs during labour were missed.

“Mabel’s death was preventable. I was never told that a uterine rupture could kill my baby or be potentially fatal for me too.

The 35-year-old said she wants to push for safer maternity care for women.

“I think it’s incredible that whilst we might have lost our little girl, potentially we, through the coroner, have saved some other families from going through what we have to go through.

“Which for me is like a little legacy for Mabel.”

The coroner also said midwives “failed to recognise numerous indicators of Mabel’s distress, and of the increasing severity of Becky’s clinical condition, and convey them to the clinical team.

Her husband and Mabel’s father, Tom Williams, said Mabel’s six days alive were “the hardest thing anyone could ever go through”.

We had one day to allow family to come and meet her, spend some time with her and read stories,” he said.

Just like our parents get to meet their granddaughter, and that was it. Just one day of that.”

A Great Western Hospitals NHS Foundation Trust spokesperson said it is “truly sorry that Mabel and her mother were not given the level of personalised, compassionate, and safe care that was needed”.

They added they have “learnt lessons” and “acted” on concerns raised by the couple and the coroner.

Professor Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists, said: ”It’s essential that maternity teams support women to make informed choices about how to give birth, including ensuring that risks and benefits of different modes of birth are fully discussed throughout their pregnancy.

Our clinical guidelines, consent advice, patient information, alongside our training and education programmes, are all designed to support maternity teams to do this well.

“We follow a robust process to develop these, with clinical and public involvement.”

A spokesperson for the Royal College said anyone with concerns should “contact their healthcare team who will be able to give advice while taking into consideration their individual medical history.