A senior midwife leading the independent review into Britain’s worst maternity scandal has said the UK should consider requiring midwives to train as nurses first, citing concerns that current training leaves new midwives unprepared to handle today’s increasingly complex pregnancies.

Donna Ockenden, chair of the Independent Review and a senior midwife, stated that midwives told her they didn’t feel “ready” when entering the profession and “not believe they have the skills to care for today’s complex women.” She explained that midwife training has not kept pace with the increasingly complex needs of mothers. Since the 1990s, the UK has allowed midwives to qualify without nursing training, meaning students could specialize from age 18.

Ockenden’s remarks follow the release on June 24, 2026, of her damning report concluding that 156 babies and six mothers died as a result of substandard care at Nottingham University Hospitals National Health Service Trust over 13 years, making it the largest maternity scandal in NHS history.

The report, drawn from the experiences of 2,500 families, painted a devastating portrait of a hospital system that repeatedly failed the most vulnerable patients in its care. Hundreds more mothers and babies survived their ordeals but were left with serious, lasting injuries, including brain damage.

Leaders at the trust were repeatedly warned of maternity problems but brushed them under the carpet. Half of senior executives at Nottingham University Hospitals refused to cooperate with the review.

Health Secretary James Murray promised to publish an action plan by December in response to the review. However, Ockenden warned: “We do not have the luxury of six months to develop an action plan.”

Murray described the findings as devastating and said a full government response to Ockenden’s national recommendations would follow in September. Pressed on whether a full statutory public inquiry would be ordered, Murray said nothing was off the table. The government moved swiftly to announce its first concrete response, committing to extend Martha’s Rule to all maternity and neonatal settings in England — giving parents the right to demand a rapid independent review if they believe a mother’s or baby’s condition is deteriorating and their concerns are being ignored.

A Pattern of Dismissal and Neglect

Ockenden’s findings describe a culture in which women’s concerns were routinely minimized or ignored entirely. Mothers who raised alarms about their babies’ movements or lack of growth were told by staff they were anxious and imagining it. The review identified a consistent pattern of families whose voices were disregarded, whose accounts were treated with skepticism, and whose legitimate concerns were downplayed by medical staff.

Women in labor arrived at the hospital seeking urgent help, only to be turned away regardless of whether they were in the early or advanced stages of labor. Others begged for pain relief that was never provided. Some gave birth alone, without any medical support present. Families who repeatedly requested caesarean sections were denied them, in some cases multiple times.

Women’s pleas for help were systematically ignored, creating an environment where dangerous practices continued unchecked for years. The failures were not isolated incidents but reflected a systemic breakdown in the duty of care.

The consequences extended far beyond the physical. Many women left the hospital traumatized, with a number later diagnosed with post-traumatic stress disorder. The psychological toll on surviving families has been profound and, in many cases, ongoing.

Shocking Individual Cases Emerge

Among the most disturbing individual accounts to emerge from the review were cases of breathtaking cruelty and negligence. Staff members were at times described in the report as “cruel,” with women in labor told to pull themselves together or wait their turn. In a separate, deeply troubling incident, an early gestation baby’s body was inadvertently disposed of as clinical waste by laboratory staff following a post-mortem examination. These failures extended into the trust’s handling of the deceased. Days before the report’s release, Nottinghamshire Police arrested two men, aged 55 and 59, on suspicion of Misconduct in a Public Office as part of Operation Perth, its criminal investigation into mortuary service practices at Queen’s Medical Centre and Nottingham City Hospital. Police said they had uncovered breaches of the Human Tissue Act relating to the management and operating practices of the mortuary services.

Families, including those of Gary and Sarah Andrews, parents of Wynter Andrews, and Jack and Sarah Hawkins, parents of Harriet Hawkins, were among those caught up in the scandal. In a solemn show of solidarity following the report’s release, Nottingham families gathered to observe a minute of silence, honouring those who lost their lives.

A Drive for Normal Birth at All Costs

A central theme running through Ockenden’s review was an institutional fixation on so-called normal births — deliveries without medical intervention — that persisted even when clinical circumstances clearly warranted otherwise. The quest for normal birth continued even as warning signs mounted around individual patients. This ideological drive directly contributed to deaths that have now been classified as avoidable.

The word “avoidable” carries enormous weight in the report’s conclusions. All 156 infant deaths were described in those terms — meaning that with proper monitoring, timely intervention and basic responsiveness to patient concerns, these children might have lived. The same applies to the six mothers who never came home.

Calls for Accountability and Systemic Change

For Jack and Sarah Hawkins, who have campaigned for accountability since their daughter Harriet’s death in 2016, that fell short. The couple said they had “zero faith” any changes would be implemented without a full public inquiry.

The Nottingham scandal follows a similar inquiry into maternity care at the Shrewsbury and Telford Hospital NHS Trust, which Ockenden also led. That earlier review exposed comparable patterns of neglect, raising urgent questions about whether the failures uncovered in Nottingham reflect a broader cultural problem within parts of the NHS.

For the families who spent years fighting to be heard — families who were told their grief was unfounded, their instincts wrong, their pleas inconvenient — the publication of the report represents a hard-won moment of truth. The review gives official acknowledgment to suffering that was real, preventable and inexcusable. For 156 children and six mothers, however, it comes far too late.