The condition and its risks
Scores of women have suffered severe complications, including emergency hysterectomies and life-threatening haemorrhage, because medical staff failed to detect they had placenta accreta spectrum (PAS), a rare but potentially fatal pregnancy condition.
PAS occurs when the placenta grows too deeply into the wall of the uterus and may block part or all of the cervix. Instead of separating naturally after birth, the placenta remains attached, making delivery dangerous. The condition is associated with a history of caesarean section – the placenta can attach to the scar tissue – and assisted fertility treatment such as IVF also increases the risk. Doctors believe the process of transferring and implanting an embryo may explain the IVF link, though they describe the additional risk as “small”.
The prevalence of PAS has risen sharply in the UK. One study reported an incidence of 1.7 per 10,000 maternities in 2010‑2011, climbing to 4.2 per 10,000 by 2013‑2015. Some international estimates put it as high as one in 111 pregnancies. The increase is linked to rising C‑section rates – in England, caesarean births now outnumber vaginal births – and growing use of assisted reproductive technology.
Diagnosing PAS remains a major challenge. Historically, only around half of cases in the UK were identified before delivery. A comparative study found that 59% of UK cases of the most severe grade (placenta percreta) were suspected before birth, compared with 88% in France and 82% in Italy. The same study revealed that postpartum haemorrhage of 3,000 mL or more occurred in 54% of UK women, versus 25% in France and 12% in Italy. The hysterectomy rate in the UK was 69%, compared with 57% in France and 100% in Italy.
Since 2020, NHS England has commissioned specialised maternity services for women diagnosed with PAS, allowing them to give birth in centres with multidisciplinary teams, adult intensive care and level three neonatal care. The Newcastle upon Tyne Hospitals NHS Foundation Trust was recognised as a specialist centre in 2019. Screening using specialised ultrasound and placental MRI is recommended at 26–28 weeks, though some centres can diagnose earlier. Updated guidance from the Royal College of Obstetricians and Gynaecologists is expected. A regional guideline for screening, diagnosis and management was published by the Newcastle trust in October 2024.
Personal accounts of catastrophic births
One hundred women who are concerned about how their PAS was managed have contacted Amisha and Nik Adhia, the couple behind the Action for Accreta campaign launched in February. The campaigners have compiled their experiences into a dossier that vividly illustrates how often the condition goes undetected. Seventy-five of the cases are from across the UK; the rest come from abroad. Worryingly, six out of ten of the women say their PAS was not diagnosed, increasing the risk of bleeding to death.
Erin Cooper from Bedfordshire was never assessed for PAS even though she regularly bled heavily from 26 weeks into her pregnancy. She delivered her baby by emergency C‑section at 33 weeks in 2024. “What I didn’t know, what no one had diagnosed, was that my placenta was abnormally and dangerously attached,” she said. “The haemorrhage was catastrophic. I lost 4.5 litres of blood. I needed a massive blood transfusion – 13 units in total – and to save my life they had to perform a hysterectomy.” Cooper, a former NHS operating theatre nurse, now suffers from PTSD. “It was like a murder scene. I have PTSD around blood. I’ve had to change jobs and can no longer work in a patient‑facing role. I get panicky when I hear sirens. I can’t drive past the hospital without feeling like I’m about to have a panic attack. I feel a deep loss of my womanhood. I’m now going into early menopause. Not a day goes by when I don’t think about being infertile at 33.”
Chloe Robinson from Burnley began bleeding heavily at home at 34 weeks in July 2024 and was taken to hospital in the middle of the night. “In theatre they discovered I had placenta accreta, something no one had suspected. They had to get several members of staff who were on call into the hospital because they weren’t prepared. I lost six litres of blood and had a hysterectomy to save my life.” Her daughter suffered a stroke during the birth and has cerebral palsy. “If they had found the condition before, none of this may have happened,” she said.
Cerri‑Anne Almond’s PAS was only discovered during her C‑section in 2021. “As soon as the surgeons opened my abdomen it became clear something was wrong. The placenta was abnormally attached to my uterus. A more specialised surgical team was urgently called in. I’m one of the lucky ones,” she said.
Beyond hysterectomy and infertility, women can suffer permanent damage to their bladder or bowels, and many experience deep psychological trauma. Kim Thomas, chief executive of the Birth Trauma Association, said: “As a charity, we have seen too many women experience deep psychological trauma as the result of PAS, particularly if diagnosis has happened late.”
Systemic failures and the fight for change
The 100 cases reveal what campaigners describe as “a dangerous gap in maternity care” and “systemic failures” that should prompt UK hospitals to do much more to train staff to spot and treat PAS. Amisha Adhia, who launched the campaign after five hospitals failed to diagnose her own PAS, said: “The fact that 61% of women in this report went undiagnosed proves that the essential infrastructure simply does not exist. There is no central data, no mandatory reporting and no national body responsible for PAS, meaning best practice stays locked away in a handful of specialist centres while women elsewhere are left unprotected.”
Politicians from all main parties at Westminster are supporting the call for a major overhaul. Jeremy Hunt, the former health secretary who chairs the all‑party parliamentary group on patient safety, said: “Nik and Amisha have highlighted an important and under‑recognised issue in maternity care. These stories and the Action for Accreta campaign highlight worrying gaps in how PAS is identified, recorded and managed across the NHS. Addressing these will require a more consistent, system‑wide approach, including improved data, training and clinical preparedness.” Hunt has urged the Royal College of Obstetricians and Gynaecologists to strengthen its identification of PAS and called for families’ concerns to be considered transparently.
The Birth Trauma Association backs Action for Accreta’s demands for updated guidelines, mandatory reporting of cases, and inclusion of PAS on maternity dashboards. Amisha Adhia met Gillian Merron, the minister for maternity care, last week and pressed her to push the NHS to do more.
Wider NHS context and ongoing reforms
The campaign’s findings come amid broader scrutiny of maternity services. Baroness Valerie Amos is chairing a rapid, independent investigation into NHS maternity and neonatal services ordered by the Health and Social Care Secretary, with an interim report published on 26 February 2026. The investigation aims to provide truth to affected families and develop national recommendations.
Martha’s Rule, implemented in NHS acute trusts across England from April 2024, allows patients, families and staff to request a rapid review from a critical care outreach team if they are concerned about a patient’s deterioration. Evidence from a pilot suggests it is saving lives.
However, there are concerns about potential cuts to maternity safety funding. Analysis by the Health Service Journal indicated a significant reduction in ringfenced national service development funding for maternity services in England, from £95m in 2024‑25 to £2m in 2025‑26. The government says the money is being reallocated to integrated care boards for local flexibility, but healthcare leaders and campaigners warn this could undermine safety improvement efforts.
On the workforce front, NHS England data from November 2023 showed a record number of nurses and midwives, with over 20,000 more staff than the previous year and over 1,100 more midwives. But a recent survey by the Royal College of Midwives revealed that about one in three newly qualified midwives are struggling to secure employment despite ongoing shortages. International recruitment of nurses and midwives has also slowed between April and September 2025 compared with the previous year.
NHS Resolution’s Maternity Incentive Scheme, which rewards trusts for implementing core safety actions, saw 102 out of 120 trusts achieve full compliance in 2024‑2025. The lowest‑scoring safety action was multi‑professional training.
A spokesperson for the Department of Health and Social Care said: “We thank these brave women for sharing their experiences. Every mother deserves to be heard and Baroness Amos’ independent investigation will help us understand the systemic issues behind the unacceptable care many families have faced.” Ministers have allocated an extra £149m to improve maternity safety, the NHS has recruited more than 2,000 more midwives, and Martha’s Rule now gives patients and their families the right to a second opinion.