Project 9: A feasibility study of the economic impact of birth trauma
Background
'Birth trauma' is a term used to describe both physical and psychological injury as a result of childbirth. When a woman is injured during birth, or if her baby is injured or dies, she can experience long-term physical and mental health effects. However, birth trauma can also happen when a woman finds the care or events during childbirth deeply distressing even in the absence of physical injury, and this distress lasts over time.
Around 1 in every 5 women who give birth in the UK report that they thought that they, or their baby, might be severely injured or die during childbirth. As a result, they recall the birth as a traumatic experience. Among this group who experience trauma, 1 in 50 women go on to develop Post Traumatic Stress Disorder (PTSD). It is estimated that this affects about 30,000 women in the UK each year.
Birth trauma and its consequences have a significant impact on the mother's wellbeing, and on the wellbeing of her child and family.
There are also costs linked to birth trauma. These include:
- Costs to the NHS (for treatment and legal claims)
- Costs to schools and social care services
- Costs to the economy, for example if parents cannot return to work
Some costs are already known. For example:
- Legal claims related to maternity care cost the NHS £3.1 billion in 2024/25
- Treating some serious birth injuries is also very expensive
However, we do not yet know the full cost of birth trauma to society in England.
Aims and Objectives
We want to find out if it is possible to measure the full cost of birth trauma in England. This includes costs to health services, education and social care, and Families and work. We will do this by looking at existing data and research to see what information is available, and what is missing. This will tell us whether it is possible to conduct a larger study using these methods.
Methods
We will use several approaches:
1. Review of existing research
We will look at studies from the year 2000 onwards to understand how birth trauma affects:
- Health care use (physical and mental health)
- Children's development and need for extra support
- Parents' ability to return to work
- Informal care (care given by family and friends)
- Legal claims
We will conduct a systematic search of academic databases and also look at reports from the government and the NHS.
2. Using existing data sources
We will analyse large datasets that collect information on health, education, and maternity care. GP and hospital records do not tell us much about how women felt during childbirth. Because of this, we will explore different ways to understand how to best identify women who have experienced birth trauma.
We plan to identify women and babies affected by physical trauma during the childbirth. We will also identify women who sought help for mental health in the first 12 months after giving birth to try to approximate how women may have experienced psychological birth trauma linked to childbirth. We will then track their health care use. This will help us estimate NHS costs and understand how common birth trauma is.
We will also look at what other data are available and how it might be used. For example, sick notes (fit notes) in routine records or responses to health surveys could help us to understand how birth trauma affects mothers' return to work. We will also explore whether we can link health data to education and social care data to help us understand children's needs after a traumatic birth.
Policy Relevance and Dissemination
At the end of the project, we will write a report for the Department of Health and Social Care, explaining what we can and cannot measure about the costs of birth trauma. We will publish a research paper showing how common birth trauma is in England for both mothers and babies. We will provide an infographic or plain English summary to help explain the results to a wider audience. These findings will demonstrate whether we can conduct a larger study on this topic, which will help policymakers understand the impact of birth trauma and plan better services in the future.
Team
Principal Investigators: Ramon Luengo-Fernandez, Oliver Rivero-Arias, Claire Carson
Wider PRU team: Marian Knight, Fiona Alderdice, Kate Fitzpatrick, Sinziana-Ioana Oncioiu, Louise Coombes
Contacts: ramon.luengo-fernandez@dph.ox.ac.uk, oliver.rivero@npeu.ox.ac.uk or claire.carson@npeu.ox.ac.uk
