Mother left with life-long injuries after giving birth breaks ‘silence’ in bid to help others
When Gill Castle became pregnant with her first child in 2011, she was over the moon. She had a healthy, straightforward pregnancy, but her labour was traumatic.
“I remember saying to my mum, I have gone into hospital perfectly healthy, a working police officer, and I have come out disabled, without my job,” Gill reflects.
“All I wanted was a baby.”
Warning – this report contains graphic content including descriptions of injuries
Gill Castle endured a traumatic labour and was left disabled after giving birth to her son
Gill’s son was premature and got stuck in the birthing canal. As his heart rate dropped, medics used forceps to save his life.
But “in doing so, they unfortunately also really significantly damaged me…”, says Gill.
As a result of the complicated delivery, Gill was left with a severe tear.
“I had a hole between my rectum and my vagina. So I was pooing out of my vagina,” Gill explains.
“Ultimately seven days after the birth, I was fitted with an emergency colostomy, which is a stoma, which I still have. Subsequently, I lost my job as a police officer due to my really severe mental health problems.”
Gill has chosen to share these details because she says she is “sick of the silence” surrounding women’s health, and is among the contributors to the very first all-party parliamentary inquiry into birth trauma.
The inquiry, led by Stafford MP Theo Clarke, was set up to address the fact that around 30,000 women each year in the UK will experience birth trauma.
Birth trauma is defined as having suffered physical or emotional distress during or after delivery. It’s so severe for some that around one in 20 women also develop PTSD.
Stafford MP Theo Clarke set up the inquiry into birth trauma in parliament
It’s a subject that’s very personal to Ms Clarke, who shared her very own birth trauma story in parliament earlier in the year.
She was taken for urgent surgery after bleeding heavily from a tear.
“I actually thought it was really important to share my story,” said Ms Clarke.
“I ended up setting up a national inquiry into birth trauma in parliament because, firstly, I was really shocked to discover there hadn’t been one before,” she added.
Since sharing her story, Ms Clarke says “hundreds of mothers across the UK” wrote into her office to share their experiences, which has helped shape the issues explored in the inquiry.
“It was very clear to me there was a huge problem with disparities in access to services for those people who had either psychological or physical trauma, like myself.
“What I really hope is this inquiry will come up with practical recommendations for the prime minister, and say ‘this is what mums are telling us they need’.”
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Ms Clarke hopes that by sharing her story and hearing thousands of others, it will raise awareness of the trauma some women experience after birth.
This is a focus of MASIC, a charity which supports women who have experienced physical birthing injuries and says such injuries are sometimes missed during birth, and dismissed after.
“There is a real postcode lottery of care,” says Chloe Oliver, chief executive of MASIC.
“The waiting list might be quite long to see pelvic health and physio specialists, and all the time you are trying to look after a baby whilst having really upsetting symptoms.”
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Ms Castle is among the contributors to the inquiry into birth trauma
MASIC is currently collating data to try to establish the emotional and financial “cost of injuries” relating to birth trauma. Not just the cost to the NHS, but the personal cost to families too.
“It impacts on your family relationships, your work life, you may not be able to go back to the job you had before you were pregnant. You know, your life completely changes and you have to live with that,” says Ms Oliver.
A Department of Health and Social Care spokesperson said: “We are committed to making the NHS the safest place in the world to give birth, and that’s why birth trauma support is among the top priorities for the Women’s Health Strategy in 2024.
“We’re increasing investment in maternity services to £186m per year from next month, to grow the maternity workforce and improve maternity and neonatal services across England. On top of that, an extra nearly £35m was announced at the Spring Budget to improve maternity safety.”
People are having to play “pharmacy bingo” – going from shop to shop to find stocks – as medicine shortages are worsening, experts have said.
Health leaders say some patients are even having to “ration” their drugs, with a new poll suggesting shortages are a “daily occurrence” for many of England’s pharmacies.
Treatments for ADHD, diabetes and epilepsy are among those affected this year, according to trade body Community Pharmacy England.
Its survey of more than 6,000 pharmacies and 2,000 staff found shortages are “wreaking havoc” on patients.
Nearly all (97%) of staff said patients were being inconvenienced, while 79% said health was being put at risk.
Some 98% said they were also giving out more “I owe yous” – where they can only fulfil part of the prescription.
Nearly all (99%) pharmacies reported supply problems at least weekly, and 72% said they were having “multiple issues a day”.
Another survey last month, by the Nuffield Trust thinktank, said drug shortages had more than doubled between 2020 and 2023 and that Brexit was likely to “significantly weaken” the UK’s ability to deal with the issues.
Shortages have also been a growing problem in Europe and the US in recent years.
However, the UK leaving EU supply chains is said to have added complications such as custom checks at borders and drug makers facing extra regulation.
Nearly all pharmacies reported problems at least weekly and 72% were having multiple issues a day
The falling value of the pound after Brexit has also made it more expensive for the NHS to buy medicines.
Community Pharmacy England boss Janet Morrison said the supply problems were “beyond critical” and had become an “ongoing battle” for pharmacies.
“Patients with a wide range of clinical and therapeutic needs are being affected on a daily basis and this is going far beyond inconvenience, leading to frustration, anxiety and affecting their health,” she added.
“For some patients, not having access to the medicines they need could lead to very serious consequences, even leaving them needing to visit A&E.”
Ms Morrison said the survey was “yet another stark warning which must not be ignored”.
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William Pett from Healthwatch England called it an “ongoing issue that continues to wreak havoc on patients”.
“Healthwatch England hears about how shortages can lead to rationing and desperate instances of ‘pharmacy bingo’, where patients must travel from pharmacy to pharmacy looking for stock,” he said.
Paul Rees, head of the National Pharmacy Association, urged the government “to sort out the UK’s fragile medicines supply system, so that pharmacies can do their job and patients can get their lifesaving medicines in time”.
The Department of Health and Social Care is yet to comment.
A British girl has had her hearing restored after becoming the first person worldwide to take part in a pioneering new gene therapy trial.
Opal Sandy was born totally deaf due to auditory neuropathy, which disrupts nerve impulses from the inner ear to the brain.
But the 18-month-old’s hearing is now almost normal – and could improve further – after having the one-time treatment.
Opal was treated at Addenbrooke’s Hospital in Cambridge and the head of the trial, Professor Manohar Bance, said results were “better than I hoped or expected” and he hopes medics might be able to cure others with this type of deafness.
“We have results from (Opal) which are very spectacular – so close to normal hearing restoration. So we do hope it could be a potential cure,” he said.
Opal (second left) with her parents and sister Nora, who has the same condition. Pic: PA
Auditory neuropathy can be caused by a fault in the OTOF gene, which makes a protein called otoferlin and enables cells in the ear to communicate with the hearing nerve.
Opal, from Oxfordshire, had an infusion of the working gene into her right ear during surgery in September – the treatment developed by biotech firm Regeneron.
Her parents noticed changes in only four weeks and the improvements were especially noticeable 24 weeks later.
Jo and James Sandy, both 33, said they were “gobsmacked” when she responded to sound tests at home without her cochlear implant, the usual way to treat the condition.
Opal had her operation in September. Pic: Cambridge University NHS Trust
“I thought it was a fluke or like a change in light or something that had caught her eye, but I repeated it a few times,” said Mrs Sandy.
They say she now enjoys the sound of slamming her cutlery on the table and playing with toy drums and wooden blocks.
“We were told she had near normal hearing last time,” she added. “I think they got responses at sort of 25 to 30 decibels.
“I think normal hearing is classed at 20 decibels, so she’s not far off. Before, she had no hearing whatsoever.”
Opal’s surgery was very similar to fitting a cochlear implant, according to Prof Bance.
He said the inner ear (cochlea) was opened and the treatment infused using a catheter over 16 minutes.
“We have to make a release hole in another part of the ear to let the treatment out because it has to go all the way through the ear,” he said.
“And then we just repair and close up, so it’s actually a very similar approach to a cochlear implant, except we don’t put the implant in.”
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Experts say it could mark a ‘new era’ in treating deafness. Pic: PA
He said the gene therapy potentially “marks a new era in the treatment for deafness”.
“It was just the fact that we’ve been hearing about this for so long, and there’s been so much work, decades of work… to finally see something that actually worked in humans… It was quite spectacular and a bit awe-inspiring really,” he said.
The treatment was developed especially for children with OTOF mutations, and a second child who has had the same surgery is also seeing positive results.
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The trial has three parts – with three deaf children, including Opal, getting a low dose in just one ear.
Another three children will get a high dose on one side. Then, if safe, a new set of children will get a dose in both ears at the same time.
Up to 18 people from the UK, US and Spain are being recruited and will be followed up for five years.
Results of the study were presented on Wednesday to the American Society of Gene and Cell Therapy conference in Baltimore.
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