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The head of an inquiry into maternity care altered its final report to remove criticism of “normal birth ideology”, one of her expert advisers claims.
Dr Bill Kirkup said Valerie Amos “listened to the wrong voices” before a section outlining the potential risks of encouraging women to have a vaginal birth “disappeared” from the final version of her government-commissioned report.
The section was removed even though “a significant number of people” had already approved the wording of that part of the document, he said. “I don’t think it’s right that we should push this issue under the covers. This is a patient safety danger and I think it should be called out as such,” he told the BBC.
Kirkup, a widely respected expert in childbirth safety, resigned as one of the 12 expert clinical advisers to Lady Amos’s nine-month-long review of problems in maternity care in England and how to improve it. He quit eight days before the former Labour cabinet minister published her 174-page report on Tuesday.
Advocates of normal birth, including many midwives, believe women giving birth should do so as far as possible vaginally, and without drugs or medical interventions such as the use of forceps or delivering the baby by caesarean section. England has unusually high rates of both procedures by international standards.
Doctors say such intervention has increased to help ensure the safety of mothers and babies at a time when the complexity of childbirth has risen, as a result of older motherhood and maternal obesity, and delays in births can lead to litigation.
The Amos report states: “Dr Bill Kirkup decided to stand down from his role on 22 June 2026 as one of the expert advisers for the national maternity and neonatal investigation as a result of not being able to agree on the specific wording of the conclusions on normal birth ideology for inclusion in the final report.”
Kirkup worked as an obstetrician and gynaecologist before running or assisting with a number of major inquiries, including into the Morecambe Bay and East Kent maternity scandals.
He told the BBC the dispute was about more than just wording. He made clear that he stood down because he did not believe that the amended final version of the report properly reflected the dangers of normal birth, which previous reports have found contributed to babies suffering avoidable harm and dying.
“A significant number of people” had approved a version of the report that did set out concerns about normal birth, he said. However, eight days before publication “it disappeared”.
That led him to resign. “We ought to acknowledge that this is a problem, and that it’s got patient safety implications for mothers and babies,” he said. “I think it needs daylight shining on it and then we can have a proper conversation about why this sometimes happens and how we make sure that it doesn’t keep on happening.”
Research by some of the Amos review team had found “that it was still an issue, at least in some places”, Kirkup said. “I think she [Amos] has listened to the wrong voices on this particular issue,” he added, without specifying to whom he was referring. The Royal College of Midwives used to tell its members to encourage women to give birth vaginally but later stopped doing so.
Amos’s report included a four-page section on “normal birth ideology”. It concluded: “On the evidence available to us, we did not find that ‘normal birth ideology’ was currently widespread in the maternity services we visited [at 12 NHS trusts] in England.”
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Amos did not respond to the BBC’s request to reply to Kirkup’s claims.
It comes as NHS bosses pledged that mothers-to-be would be able to seek help and advice from a 24/7 triage service at all 155 maternity units in England within a year.
NHS England said the move would ensure they had easier access to care from a midwife on the phone if they had any concerns about their pregnancy. It is part of a new 10-point NHS plan to improve childbirth services after Donna Ockenden’s report last week on the maternity scandal involving Nottingham University hospitals NHS trust, and Amos’s findings.
Some hospitals already provide a telephone triage service but only a handful operate theirs around the clock. They include Queen’s hospital in Romford, east London. It expanded its service to 24/7 as part of a determined effort to improve the quality, safety and speed of its maternity care, which helped it get rated “good” by the NHS regulator.
Women typically ring triage helplines because they are worried that their waters may have broken or that their baby has stopped moving.
Kate Brintworth, England’s chief midwifery officer, said such services would be “giving every pregnant woman and new parent in England the comfort of knowing they will always have a midwife on the end of a call to answer their concerns if they are experiencing an emergency”.
“This modernises maternity services so that pregnant women and parents who urgently need expert advice will no longer be left waiting for a call back or directed to a maternity unit voicemail. Instead, they will get specialist advice straight away, helping them get the right care more quickly,” she said.
