WARNING, DISTRESSING CONTENT: A ‘money hungry’ private maternity industry has sprung up in recent years, taking advantage of anxious mothers facing the biggest change of their lives
In the UK, the journey to parenthood is governed by some of the world’s strictest medical standards – until you step outside of the NHS. An investigation has exposed a regulatory vacuum in the private maternity sector, where experts with as little as three days of training are making life-and-death decisions.
From under-qualified maternity nurses giving deadly sleep advice, doulas fatally ‘interfering’ with labour, to money-hungry high-street scan clinics failing to spot severe abnormalities, the cost of this profit-driven industry is being paid in infant lives and shattered families.
As grieving parents demand an end to these legal loopholes, the message is clear: in the private maternity market, “qualified” doesn’t always mean safe.
Charlotte Tolley, 36, is a single mother of three children, one of whom requires intense amounts of care: her five-year-old son, Lucas. The little boy was born with half of his brain missing, which the private clinic that Charlotte used during her pregnancy didn’t notice.
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Currently, anyone with an ultrasound machine can use that title, prompting Charlotte to campaign for change. She is urging other families to not rely on private scans, and for sonography to become a regulated industry, so no other families go through the heartbreak she has faced.
The mum-of-three opted for private scans after suffering a miscarriage. At her first NHS appointment, she found herself in the same room where she’d lost her last baby. After discussing options with her midwife, she opted for a private clinic, where they found Lucas to be healthy, even though the abnormality was clearly visible on ultrasound.
Charlotte said: “Everything was quite standard and normal. I specifically asked the sonographer, ‘Can you see anything wrong? Would you be able to see if there’s any abnormalities?'” But after he was born, Charlotte knew something was wrong. To complicate things, the pandemic had just begun, and in-person services were becoming less easily accessible.
The tot struggled to feed, or focus, and suffered from jaundice. After he continued to struggle, Charlotte listened to her “mum gut” and called an ambulance.
She told the Mirror: “Had I not already been a mum of two children, I don’t think Lucas would be here now to be honest with you. He was chronically dehydrated, he was yellow, he had mottled skin, his head was bigger than his body, he looked like an alien where he’d not been able to gain any weight.
“He was constantly in and out of consciousness where he could barely stay awake because he had no energy to him.”
At the hospital, a doctor conducted a cranial ultrasound – and what he saw caused him to panic. “He dropped the ultrasound machine, literally dropped it and went off,” said Charlotte. “He got on the phone to somebody, looked quite panicked, came back to me and said: ‘Your son has half of his brain missing’.” Charlotte could not believe what she was hearing – questioning how could her baby be alive without an entire brain – and Lucas was rushed for an urgent MRI.
The scan confirmed that Lucas’s brain was half-missing. “It was so obvious, you know, I’ve never seen an MRI of a brain before in my life, but even I could tell that it wasn’t right.”
Further tests were undertaken on the little boy, only weeks old, including hormone profiling that required bloods to be taken every three hours. “His brain didn’t develop, half of his brain was missing, his midline brain was missing. He’s completely blind, he’s got cerebral palsy, epilepsy, he can’t chew or eat because of his CP. I was told at the time, he would never walk, talk, eat, smile, do anything.”
When another MRI was being conducted a healthcare worker “at the top of her profession” commented to Charlotte that she must have had a difficult pregnancy – when Charlotte told her she had no idea there were any abnormalities during her pregnancy at all, the medic was left “shocked”.
“It was from that I realised that you know something had gone wrong we’ve been not given the proper treatment,” Charlotte explains. She met with a solicitor, and experts throughout the fields of radiography and ultrasound – and looking at the scans the private clinic had provided her with the experts confirmed that “undoubtedly you can see there’s a problem.”
So why didn’t anyone tell Charlotte that her unborn son only had half a brain? “Either he wasn’t qualified enough or he was told not to say anything,” Charlotte says, citing reports by the BBC that indicate some technicians at private clinics were told not to disclose certain information to their clients. Whatever the reason was – Charlotte was let down by a service that she thought she could rely upon to keep her baby safe. She reached an out-of-court settlement with the clinic that was responsible for her failed scans.
If the abnormality had been reported to her, she should have been immediately sent back to the NHS and provided with a pregnancy-safe MRI. “Then I would have been told this child is likely not to be able to walk, talk, and do all of these things and it would have been my choice,” whether to continue with the pregnancy, Charlotte says. Admitting that “as awful as it sounds,” she would have “definitely had to” terminate the pregnancy “because I had two other children, I was a single parent that just left a marriage, and my eldest daughter is autistic as well. So there’s no way I would have looked at that and thought I could cope with everything, and to be honest with you, I don’t know how I have, but, you know, as a parent you just keep going, don’t you?”
Charlotte certainly has kept going. The progress her son Lucas has made is astounding compared to the “bleak” prognosis he was given as a baby. “We’ve worked really hard with him and he’s a happy little boy. He does walk and he uses his cane and he does need to use a wheelchair sometimes but he does much better than the bleak outlook we were given.”
But Lucas needs an intense amount of care round the clock, and as a single mother, Charlotte is under a huge amount of pressure. “I’ve now got to the situation where I sometimes almost wish that I could outlive my own son because I’m worried for the future that he will have if he’s left on his own without any support. I do everything for him, and I always will have to even as he gets older, and no parent should ever have to feel like that.”
Charlotte feels strongly about some of these clinics that are cropping up across the UK. “Personally speaking, I think these other clinics should be avoided altogether. [Some] are money hungry vultures, they are literally there for profit, they do not care about the people walking through their doors, they’re not interested, they just want to build a franchise, build a name and earn money and that’s it.”
She has launched a campaign to try and ensure that what happened to her – or anything like it – is not something that any other parent has to go through. She wants to make sonography a regulated profession and has started a petition to try and enforce greater transparency in this area.
Amy Heath, Medical Negligence Partner at the law firm, Stewarts who acted for Charlotte warns that her client’s “example is an extreme one, but it’s a good one to show how wrong it can go.” Amy explains that the NHS – for the most part – “mops up” the errors these private clinics which are “money making enterprises” make. “They’re not there to provide healthcare,” the medical negligence expert claims, “They’re there to make money.”
In November, the Society of Radiographers warned about the risks of using high-street baby-scan clinics. Whilst Charlotte’s case might be an “extreme” one, it is all too common that issues are slipping through the net. As the Society of Radiographers has pointed out, anyone with an ultrasound machine can call themselves a sonographer.
“One time, we had a lady referred in from a private clinic, who was eight or nine weeks pregnant,” says Elaine Brooks, a former hospital sonographer and Midlands regional officer for the SoR. “The sonographer at the private clinic said there was no heartbeat for the baby and that the baby was very, very malformed, and they sent her in for an induced miscarriage.
“The trust I was working in never accepts reports that come in from private clinics, so we started scanning the lady, who was in tears. On the scan there was clearly a beautiful nine-week pregnancy with a heartbeat. It was absolutely fine.
“Next to the pregnancy was a blood clot, what they’d done is measured the blood clot. But there was a fetus of normal appearance above it. If the hospital had given her the medication the private clinic had recommended, that baby would have miscarried.”
Private clinics also offer parents-to-be gender scans ahead of the 20-week hospital scan. “On occasion we see people come in for their 20-week scan having had a private scan a week or two before,” says Ms Brooks. “And then they come for their NHS scan and there’s quite a large abnormality that should have been picked up – something like spina bifida, polycystic kidneys or fluid-filled ventricles in the head – things that you wouldn’t expect to have developed in a week.”
It’s not just the babies being putting a risk – so, too, are the mothers. Ectopic pregnancies occur when a fertilised egg implants outside the uterus, most commonly in a fallopian tube, making it a life-threatening, non-viable pregnancy. “Ectopics are not an unusual occurrence: the clinic will say they can’t see the pregnancy,” says Ms Brooks.
“But when the woman is scanned again in a hospital setting, it’s diagnosed as an ectopic – which is an obstetric emergency.” An undetected ectopic pregnancy is life-threatening to the mother.
Experts have also warned about another possible risk – the use of unregulated birthing assistants. In January, a coroner warned that more babies could die without greater clarity and guidance over the role of home birthing assistants, after the death of a 15-day-old baby girl.
Newborn Matilda Pomfret-Thomas died of a brain injury in November 2023, which was caused by a lack of oxygen to the brain either before or during birth. Her mother had experienced a difficult home labour and was not immediately transferred to hospital – despite signs of foetal distress, an inquest concluded.
Hampshire assistant coroner Henry Charles noted that midwives from Portsmouth’s Queen Alexandra hospital felt their access “was being restricted by the doula” when the child’s mother went into labour on 29 October 2023.
A midwife who attended the home birth first offered a transfer to hospital at 7.19am when meconium – a sign of foetal stress – was discovered, the coroner said. The offer was turned down, and again at 10am despite “deteriorating” labour, because it was “not communicated [to the family] in such a way as to lead to a transfer to hospital”.
Charles said: “The presence and work of a doula did on this occasion negatively impact upon the effective provision of midwifery services in terms of building a rapport conducive to effective advice and care being given.
“I found that [the doula] did not actively discourage midwife access but that she was seen as, in effect, a buffer by members of the midwifery team. The doula was following the birth plan. The doula was supporting the parents per the birth plan, and this appears to have been perceived as grounds for hope that a home birth was still possible.” The coroner has called for a review and regulation on doulas and the training they receive.
Katie Vale, a Milliner, who runs her own company, Katie Vale Designs, told the Mirror about her experience using a doula during her pregnancy with her daughter Verity, now four – an experience she “regretted” and she found anxiety inducing. “I wanted a natural birth. I haven’t always had the best experience with Western medicine and treatments, and I felt as if I wanted to bring my daughter into the world calmly, as nature intended, not with medication pumping into us both before she has even been born,” the designer tells the Mirror.
“It was during COVID, so I couldn’t meet in person, but had followed several online for a while. I reached out to a lady who was doing a series of online classes and 1:1 sessions.” Katie and her mum – who was her birthing partner – met with the doula several times over Zoom, “going over expectations, debunking myths, and telling us a bit more about the natural birthing process.”
Katie explains, “She really drummed home that we should be refusing medication and intervention. And whilst ultimately whilst I am an adult, I choose what happens and I’d sought her out, I came away a bit anxious. Yes, I was happy to listen to what she was saying overall, but I also believe that if medication was needed, I would have it.” Katie also points out that during that time in-person resources like birthing sessions had, for the most part, been cancelled, so online resources were the best bet for new mums looking for support.
Whilst the doula did not attend Katie’s labour, the advice she had given the designer lingered in the room, and when things started to go wrong with the birth, Katie felt as though there were “anti-vaxxers in the room shouting at me”.
“I had problems during my maternity and labour, that eventually ended up with an emergency C-section,” Katie explains. “Things were quite fraught and both myself and my daughter were in significant danger at one point. We are both fine now. However it very much felt as though when I was in the midst of labour I was feeling panicked about the medication they were using, I kept thinking about what the doula had said. All in all, I felt mum guilt immediately. I suddenly felt like I had anti-vaxxers in the room shouting at me telling me what a bad job I was doing and how all this medication was going to damage my perfect little girl.”
However, Katie was at pains to point out that she didn’t blame her doula, or think badly of the profession in general, “I blame myself for seeking her out,” she says.
In 2023, The Maternity and Newborn Safety Investigations (MNSI) warned that doulas were involved in 29 of the 2,827 maternity investigations it had completed. It said it “found evidence in 12 of the 29 investigations that doulas worked outside of the defined boundaries of their role. The care or advice provided by the doula was considered to have potentially had an influence on the poor outcome for the baby”.
In one of these cases the doula had encouraged the mother to stay at home “in direct conflict with the advice from the midwifery team to urgently transfer to the hospital. The significant delay in transfer to hospital contributed to the baby having a severe brain injury”.
Doula UK pushed back on the idea of regulating the profession to the Mirror. In a statement to the Mirror, they said: “Doulas support thousands of families each year by offering compassionate emotional, informational and practical care throughout pregnancy, birth and the postnatal period, working alongside midwives and doctors to help families feel informed and supported. Doula UK members undertake approved training, mentored practice and ongoing professional development, guided by a shared code of conduct. We would therefore recommend parents find a Doula UK registered member.”
Women searching for extra support during one of the most challenging periods of their lives goes beyond pregnancy and labour itself, with unregulated and unqualified “night nurses” also posing a major risk to infants.
An inquest last week heard that a four-month-old baby, the grandson of football manager Steve Bruce, tragically died after being placed in an “unsafe sleeping position” by an unregulated maternity nurse. The parents of Madison Bruce Smith had employed Eva Clements via Ruthie Maternity Services in the belief that she was fully trained, skilled and vetted, and that the firm was well established. In fact, neither was regulated Stockport Coroner’s Court heard.
The inquest was told that Madison’s parents would “never have dreamed” of putting their son asleep in the prone position had it not been for the advice of the maternity nurse, who was said to have informed them all four of her own babies had slept on their stomachs with no problems. Such advice is contrary to recognised safe sleeping guidance from the NHS and health professionals for young babies.
It has since been confirmed that Ruth Asare, head of Ruthie Maternity Services, had no medical qualifications and had only a first aid certificate and a Level 2 diploma in post-natal care, which she gained from a three-day course and a six-month coursework project. Clements said she had a degree in early years education but admitted she also had no medical qualifications.
The case led the senior coroner for south Manchester, Alison Mutch, to issue a prevention of future deaths report to the Secretary of State for Health calling for regulation.
An NCT spokesperson told the Mirror: “When it comes to sleep, understanding what makes a place safe to sleep is key. The safest place for a baby to sleep is in the same room as their caregiver. This should be for at least the first six months, both day and night. A separate sleep space is considered safest, with the baby on their back on a firm, flat and clear surface. Sleeping on their side or front greatly increases the risk of SIDS, so put the baby on their back to sleep as a routine from day one. Once they can move themselves from their back to their front and back again by themselves, there is no need to worry but you can carry on placing them on their back to sleep when putting them in their sleeping space.”
Kate Marsh, midwifery manager for Tommy’s, the pregnancy and baby charity, told the Mirror: “Our hearts go out to the families of Madison and Matilda, whose lives have been devastated by their loss.”
Not every mum who spoke to the Mirror about their experiences had negative impressions of the private maternity industry by any means – but almost all of them described a sense of anxiety, and a lack of support as their motivation for seeking out these supplementary services.
Nutritionist therapist Hanieh Vidmar opted for private care, citing long waiting times within the NHS, and concerns about overstretched resources
She said: “I think there needs to be more support and education for first time mums when giving birth. They opt in for things like doulas and night nurses thinking they absolutely need one and when they don’t know what they are looking for, and should look for, [it] can cause serious issues. I think that’s the issue.”
“There’s a misconception that private means better,” explains Amy Heath, explaining that these private industries are an “increasing problem because we’ve got the situation where people are losing faith in NHS maternity services,” and a growing mistrust in the medical profession, but something must be done: “It’s preying on people at their most vulnerable”.
For support after baby loss, please contact Sands’ national helpline on 0808 164 3332 or email [email protected]
Sign Charlotte’s petition to make sonography a regulated profession in the UK here
