What you can complain about

Birthrights, which advises on maternity rights in the UK, frames it broadly. Be clear on "what poor treatment/poor behaviour/poor communication you want to complain about", and it states the standard you are entitled to: "You have the right to receive care that is personalised to your specific health circumstances and to always be treated with dignity and respect."

That covers more than clinical error. Being spoken to badly, being examined without consent, being ignored when you said something was wrong, being pressured into a decision, having a plan disregarded — all of these are complainable, and none of them require a bad clinical outcome.

NICE's own recommendations describe the same standards from the service side: a culture of respect, treating women "with kindness, dignity and respect", explaining procedures before they take place and asking for consent, and ensuring a woman understands she can decline care without it affecting how care is provided.

Get your notes first

Almost everyone who has done this says the same thing: request your maternity records before you write anything. You do not need a reason, and Birthrights says the NHS has committed to providing healthcare records within 21 days, with a legal limit of 40 days for a formal subject access request.

Two reasons. First, the notes tell you what was recorded, which is what any investigation will start from. Second, they often answer the question you were going to ask, which can turn a complaint into a debrief instead.

Birthrights adds a piece of advice worth following while you wait: "you may find it helpful to write down what you remember about the events". Memory of a birth degrades and reshapes quickly, and your own contemporaneous account is evidence too.

Decide what you actually want

This is the step people skip, and it shapes which route to use. Common outcomes people want:

An explanation of what happened and why.
An apology.
A correction or addition to your records.
A change in practice so it does not happen to someone else.
A plan for a future pregnancy at the same trust.
Formal investigation of a specific incident.

If what you want is an explanation, a birth debrief may get you there faster than a complaint. NICE's postnatal guideline asks that women be given the opportunity to talk about their birth experience and be told about birth reflection services where appropriate. If what you want is accountability or change, a formal complaint is the right instrument.

You can do both, and doing one does not stop the other.

PALS, and what it is for

The NHS describes the Patient Advice and Liaison Service as offering confidential advice, support and information on health-related matters, and help with resolving concerns or problems when you are using the NHS. PALS is not a complaints department; it is the front door for finding out who deals with what.

It is the right first call if you want to know whether your trust runs a birth reflections service, who to address a complaint to, how to request your records, or simply what your options are. Birthrights points women to PALS for exactly this.

Making a formal complaint

Birthrights sets out a step-by-step process, and the shape of it is consistent across the UK: decide what you are complaining about, decide what you want to happen, gather what you need including your records, write it, and send it to the right place — normally the complaints team of the trust or board, by post or email.

Practical things that make a complaint work better:

Put the events in date and time order, using your notes for the timings.
Separate what happened from how it felt, and include both, clearly labelled.
Number your questions, so each one has to be answered rather than absorbed into a narrative reply.
Say what outcome you want at the end.
Keep a copy of everything, and note the date you sent it.

There is normally a time limit for NHS complaints in the UK of twelve months from the event, or from when you became aware of it, with discretion to accept later complaints where there is a good reason. If you are near or past that point, say so and explain why.

If the answer is not good enough

There is an ombudsman stage after the local complaints process is exhausted. Birthrights: if you are not happy with the way an NHS body in England answered your complaint, "you can refer it to the Parliamentary and Health Service Ombudsman", and you should do that within 12 months of receiving the response. It notes the Ombudsman "is independent" and that while it "does not have punitive powers ... it can make strong recommendations which a Trust must not ignore". Birthrights also notes that the complaints process "varies slightly between countries", so check the route for the nation you are in.

If the problem is a refusal to give you your records, the regulator is the Information Commissioner's Office, which Birthrights names as the route for that specific issue.

If you think a specific registered professional acted unsafely, professional regulators exist — the Nursing and Midwifery Council for midwives, the General Medical Council for doctors. These are separate from the trust complaints process and address fitness to practise rather than your care as a whole.

Complaining while you are still pregnant

It is allowed, and it should not change your care. NICE's expectation is that decisions a woman makes "will not affect how care is provided to her", and Birthrights' human rights material is built on the same principle.

In practice, if you are still under the same team it is often worth asking for a meeting with the head of midwifery or a consultant midwife first, and saying plainly that you want a plan for the rest of this pregnancy as well as an answer about what happened. That combination tends to move faster than either alone.

Look after yourself while you do it

Complaints are slow, and reading your own notes can be harder than expected. Set a pace, ask someone to read drafts with you, and be honest with your GP about the effect it is having.

NICE points teams to its guidance on traumatic birth and post-traumatic stress disorder in the same breath as birth reflection services, which is a recognition that the events being complained about are often the ones that cause harm. A complaint is a process, not a treatment, and needing both is common.

What it can change

Trusts are required to respond, to explain, and to say what they will do differently. Individual complaints have changed local policies on consent, on birth partner access, on debrief services and on record keeping.

It is also worth knowing what a complaint cannot do: it will not rewrite the record of what happened, and it is not a route to compensation, which is a separate legal process. Being clear with yourself about that at the start protects you from the disappointment of expecting the wrong thing from it.

Complaining About Maternity Care