About the roundtable event
A high-level roundtable at University College London has brought together senior policymakers, NHS leaders, clinicians, charity executives and bereaved parents to highlight that communication is a determinant of care quality, safety and equity.
The event, Improving Communication During Adverse Gestational Events, brought together a panel of leading figures including national maternity leadership from NHS England, Members of Parliament involved in maternity policy, senior clinicians, and chief executives of major pregnancy charities, alongside individuals with lived experience of baby loss.
The discussion took place against the backdrop of the Independent National Maternity and Neonatal Investigation, which has identified communication failures – such as women “not being listened to” and lack of clarity in healthcare interactions – as recurring, systemic issues across England’s maternity services.
A high-profile coalition across policy, practice and lived experience
Chaired by UCL health communication specialist Dr Beth Malory, the roundtable brought together a cross-sector group to discuss the importance of communication – how information is shared, understood and acted upon – in pregnancy care.
Participants included:
- Professor Donald Peebles, National Clinical Director for Maternity at NHS England
- Kate Brintworth, Chief Midwifery Officer at NHS England
- Members of Parliament Michelle Welsh, Alison Bennet, and Saqib Bhatti, who lead maternity and baby loss policy groups
- Leaders from national charities including the Miscarriage Association and Tommy’s
- Senior obstetricians and training leads, including the Director of the UCL Institute for Women’s Health Professor Anna David, the Director of the Tommy’s Maternal and Fetal Medicine Research Centre at the University of Manchester Professor Alex Heazell, and Dr Karen Joash, head of speciality training for Obstetrics and Gynaecology in London
- Bereaved parents, campaigners, and public contributors
This combination of national policy influence, frontline clinical leadership and lived experience shaped what several attendees described as a “pivotal” discussion.
“Communication is not secondary to care”
Opening the event, Dr Malory set out the central premise: that communication is not a “soft skill”, but a determinant of care quality, safety and equity.
That position was echoed by senior NHS leadership. England’s Chief Midwifery Officer, who stated that communication is “fundamental to everything we do in maternity”. MP Michelle Welsh agreed but argued it has too often been treated as optional, a “nice to have”, rather than a “must have”.
Across the discussion, participants repeatedly linked communication failures to long-term harm. One MP described how inadequate explanations following complications can have lifelong consequences for families, while another warned that without change, “we will have a problem for years and generations to come.”
Clarity: “No one actually said the word”
A central theme emerging from both professional and lived experience perspectives was the absence of clear, direct language at critical moments.
Bereaved parents described not being explicitly told they had experienced a pregnancy loss, instead piecing together information themselves after leaving hospital. One noted that many women report that “no one actually said the word miscarriage,” leaving them with unresolved confusion and distress. Vicki Robinson, CEO of the Miscarriage Association, confirmed that this is a common experience.
Participants highlighted the tension between sensitivity and clarity, but agreed that avoiding clear language can cause greater harm. As one bereaved mother explained, euphemisms can lead to dangerous misunderstandings, particularly in contexts involving neurodivergence or where English is an additional language.
Clinicians acknowledged that this gap reflects inconsistent training. Senior educators noted that many healthcare professionals are not adequately prepared to deliver difficult news, particularly in increasingly complex, diverse patient populations.
Risk: “Why aren’t we told?”
A second major theme was the communication of risk, and the consequences of withholding or diluting it. Lived experience participants argued that patients are not routinely given sufficient information about potential complications, particularly in early pregnancy. One bereaved mother described repeatedly asking about warning signs, only to later discover she had experienced, and complained of, symptoms of a serious condition that had not been explained to her and which ultimately led to her daughter’s death.
Other panellists stressed that communicating risk is not about causing fear, but about enabling informed decision-making. As Professor David of the UCL Institute for Women’s Health put it, patients must be told clearly what symptoms to watch for and when to seek help, especially in high-risk scenarios.
This issue was also linked to persistent inequalities. Evidence cited in the discussion highlighted that women from Black and South Asian backgrounds are more likely to have their concerns dismissed or their pain underestimated, leading to delayed care and worse outcomes. A leader from the national charities Tommy’s noted that these experiences are not isolated but “the same stories that we continually hear” across communities.
Education: from professionals to patients and communities
A third dominant theme was education, across the entire communication ecosystem.
Participants identified gaps at multiple levels:
- Professional training, with limited focus on bereavement communication
- Patient education, particularly around communication of pregnancy risks
- Public and community understanding, including the role of partners and families
Several speakers argued that current approaches introduce risk information too late, often only after complications arise. One participant suggested that communication about risks should begin at the very first appointment, not during crisis moments.
Others emphasised the growing role of social media and informal information sources, arguing that healthcare systems must engage more proactively rather than treating clinical communication as the sole authoritative voice.
From “nice-to-have” to system-level change
The most urgent messages came from policymakers, who warned that incremental improvements would not be enough. Michelle Welsh, MP, Chair of the All Party Parliamentary Group on Maternity, described communication as currently treated as a “nice-to-have,” arguing instead that it must be embedded structurally within maternity services.
Calls for change included:
- Embedding communication standards into policy and clinical guidance
- Strengthening training across the maternity workforce
- Improving continuity of care and access to advice
- Leveraging technology to provide consistent, accessible information
- Working more closely with charities and community organisations
Senior NHS leaders acknowledged that while evidence of the problem is now overwhelming, the challenge lies in implementing solutions at scale across a large and pressurised workforce.
A “pivotal moment” for maternity care
The roundtable concluded with a shared sense that the ongoing Maternity and Neonatal Services Investigation, which is due to publish its findings in June, presents a rare opportunity for meaningful change.
Participants agreed on three key takeaways:
- Communication must be recognised as a core component of care quality and safety
- Changes must prioritise those currently least well served by research and the healthcare system
- Progress will require coordinated action across policy, services, research, and lived experience leadership
As Professor Donald Peebles, Clinical Director for Maternity at NHS England noted, the sector has moved beyond asking whether there is a problem: “there is so much evidence… we now move into solutions.”
With national attention focused on maternity services, the discussion at UCL made clear that communication must be central to any lasting change.
Photos from the event
Group photo:
- Back row (left to right): Saqib Bhatti, MP; Alison Bennett, MP; Kate Brintworth; Helena Morais; Professor Donald Peebles; Professor Anna David
- Front row (left to right): Dr Beth Malory; Dr Karen Joash; Dr Jyostna Vohra; Shriya Pancholi; Vicki Robinson; Michelle Welsh, MP; Professor Alex Heazell
