National Maternity and Neonatal Investigation: Interim Report Released

On 26 February 2026 the National Maternity and Neonatal Investigation released its interim report.

The investigation, launched in June 2025 and chaired by Baroness Valerie Amos, aims to get to the heart of why unsafe or inconsistent care still happens and why inequalities persist, particularly for Black, Asian, and socioeconomically disadvantaged families. This is an important milestone in a nationwide effort to understand and address systemic problems in maternity and neonatal care across England.

The interim report does not include formal recommendations; these are expected within the final report. Instead it comments on the changing landscape of maternity and neonatal services and the key pressures affecting the system today.

Changing Context

The report highlights that although national ambitions set back in 2016, including an aim to halve the rates of stillbirths, neonatal mortality, maternal mortality and brain injuries, led to early improvements progress has stalled and, in some areas, has reversed. A worrying example given is the increase in maternal mortality, rising from 8.8 per 100,000 maternities to 12.8 in the period between 2017 to 2019 and 2022 to 2024.

The report also notes that the needs of women using maternity services have changed significantly. More women are having children later in life, more have pre existing medical conditions, and there remain stark inequalities in outcomes for Black, Asian, and deprived communities. Clinical practice is shifting too, with planned caesarean rates rising greatly since 2011.

Six Key Pressures 

The interim report highlights six areas that may be driving strain across the maternity and neonatal system:

1. Capacity Pressures

Services are experiencing demand issues at almost every stage. Long waits, reduced service availability, and inconsistent care are common themes. On top of this, outdated or inefficient IT systems create frustration for both families and staff.

2. Culture and Leadership

The report stresses how vital organisational culture is for safe and compassionate care, but many staff describe experiencing poor teamwork, low morale leadership gaps, and the emotional toll of constant public scrutiny.

3. Racism and Discrimination

Inequalities in outcomes remain a core concern. Families and staff shared experiences of stereotypes, insensitive communication, and discriminatory behaviours that undermine trust in the system and affect the safety of care.

4. Poor Responses and Lack of Accountability When Things Go Wrong

Families described a lack of compassion and transparency following incidents involving harm. Some spoke of not being involved in investigations and having concerns about there being a “cover up” and feeling that they had no option but to pursue claims. The report refers to the litigation process potentially contributing to defensive practice amongst some clinicians. 

5. The Quality of Estates

During visits to 12 NHS Trusts, the investigation found many maternity and neonatal services being delivered in buildings that are outdated, cramped or poorly designed. Poor layouts, limited space, and inadequate facilities can compromise safety and make what should be supportive environments feel distressing, especially during bereavement.

6. Workforce

Inadequate staffing remains a consistent issue, creating highly pressurised work environments. Families noted that overstretched or unsupported staff can unintentionally contribute to distressing experiences, while the presence of well staffed and well supported teams makes a profound positive difference. The report highlights how morale, communication, and access to specialist support varies widely.

What Happens Next?

The investigation now moves into its final stage, completing its evidence gathering and analysis before issuing national recommendations. The goal is to deliver meaningful reform across maternity and neonatal services and improve care for both families and staff.

According to the government, the full report and recommendations are expected to be published in Spring 2026.

Comment

There is no doubt that there is no quick fix to any of the key pressures identified by the interim report. It contains a number of examples of concerning and, at times, sobering accounts obtained from both patients and staff. However the report does put a much needed spotlight on more human focussed, qualitative information and not just statistical data. 

Although the interim report is at times difficult to read, it is encouraging that the investigation is now working towards the recommendation phase. It is hoped that it will help NHS Trusts, and the wider system, better understand what is needed to achieve the national ambitions set back in 2016, for both patients and clinicians alike.

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