Severe childbirth injuries in England have reached an all-time high, with nearly 1 in 20 women now suffering serious harm during delivery, according to new NHS data. The figures, released by NHS Digital, show that the rate of third- and fourth-degree perineal tears—the most severe form of childbirth injury—rose to 4.8% of all vaginal births in 2025-26, up from 4.5% the previous year and 2.9% a decade ago.
What the Data Reveals
The data, covering all NHS hospitals in England, indicates that 28,434 women experienced such tears in 2025-26, compared to 26,915 in 2024-25. These injuries involve damage to the anal sphincter and sometimes the rectal lining, often leading to long-term issues such as incontinence and pain. The rise has been attributed to factors including increasing maternal age, higher rates of induction, and greater use of forceps or ventouse deliveries.
Impact on Women's Health
Women who suffer these injuries often face significant physical and psychological consequences. According to the Birth Trauma Association, many women report feeling “devastated” and “abandoned” after such experiences. A spokesperson for the association said, “These figures are a stark reminder that childbirth remains a dangerous event for many women. The NHS must do more to prevent these injuries and provide proper aftercare.”
The Royal College of Obstetricians and Gynaecologists (RCOG) acknowledged the problem, stating that while some tears are unavoidable, better training and use of techniques such as perineal massage and warm compresses could reduce the risk. Dr. Ranee Thakar, president of RCOG, said, “We need to ensure all maternity units have access to the best evidence-based practices and that women are informed about the risks.”
Regional Variations
The data also reveals significant regional disparities. The highest rate was in the East of England, at 5.6%, while London had the lowest at 4.1%. Experts suggest this may reflect differences in clinical practice, such as the use of episiotomy, which can sometimes prevent severe tears if performed correctly.
Calls for Action
Patient safety groups are calling for a national strategy to reduce the incidence of severe tears. The charity Birthrights said the figures were “unacceptable” and demanded that the government invest in midwifery-led care and reduce unnecessary interventions. “Women are being failed,” said a Birthrights spokesperson. “We need a cultural shift in maternity services that prioritises physiological birth and respects women’s choices.”
The NHS has pledged to address the issue, with a spokesperson saying, “We are committed to improving safety in maternity care. New guidance on perineal protection and repair has been issued, and we are rolling out training for all maternity staff.” However, critics argue that more funding and staffing are needed to implement these changes effectively.
