Brace yourself: a rare childbirth complication is slipping through the cracks in our NHS, putting mothers and babies at serious risk. Here’s why this matters and what’s being done to fix it.
Amisha Adhia is launching a campaign to push the NHS to improve how it diagnoses placenta accreta spectrum (PAS), a condition that can be life-threatening if not identified before labor. After five hospitals failed to recognise her condition, she and her husband, Nik, created the Action for Accreta campaign to raise awareness and spur action.
PAS is more likely in women who have had a previous Caesarean section or who have undergone IVF treatment. If doctors don’t spot it before birth, a mother may face emergency hysterectomy or fatal bleeding during delivery.
Estimates vary widely, with the NHS stating PAS occurs in roughly 1 in 300 to 1 in 2,000 pregnancies. Some researchers in the US and Israel have suggested the rate could be as high as 1 in 111 pregnancies. What’s clear is that the risk picture is shifting upward because more babies are being born by Caesarean section in England (about 45%) than vaginally (about 44%), a trend that could raise the number of PAS cases over time.
Adhia describes a frightening experience: despite multiple assessments at five London hospitals, she was told she did not have PAS. It wasn’t until Dr. Chineze Otigbah, a consultant obstetrician at Queen’s Hospital in Romford, evaluated her that PAS was diagnosed. Her timely intervention meant Adhia could receive proper care when delivering her daughter, Ishaani, last September.
“I’m alive today because a doctor recognised the danger and acted,” Adhia said. She describes being reassured into danger, carrying a condition that could have killed both her and her baby, and feeling unheard and dismissed at several points during her pregnancy journey.
The couple has since connected with around 40 other women who experienced complications or setbacks because PAS was not diagnosed during pregnancy or labor, many of whom reached out after seeing their posts on social media.
There is currently no national figure on how often PAS develops or causes problems because the NHS does not systematically record this information. Even the annual MBBRACE-UK maternal health report doesn’t provide PAS specifics. Some international studies, however, suggest the condition may be more common than previously thought.
Eight maternal and baby health groups have publicly supported the campaign, including Birthrights and the Birth Trauma Association. Tommy’s and Sands, two baby charities, also welcomed the effort, noting it highlights important gaps in awareness, surveillance, and learning about serious pregnancy complications.
The Royal College of Obstetricians and Gynaecologists (RCOG) acknowledges that PAS and placenta praevia can cause major bleeding and both are linked to rising maternal and neonatal morbidity and mortality. The college expects rates to continue rising with higher Caesarean rates, older maternal age, and wider use of assisted reproductive technology.
The Adhias recently provided evidence to Valerie Amos’s inquiry into maternity care in England, which was ordered by Health Secretary Wes Streeting. They urged that the inquiry include recommendations for better identification of PAS within the NHS.
Dr. Otigbah stresses the main concern: risk factors for PAS—Caesarean sections and IVF—have grown, yet some hospitals lack PAS specialists, making subtle warning signs easy to miss. The couple hopes the RCOG’s updated guidance will include clearer recommendations for diagnosing and managing this atypical PAS form.
An RCOG spokesperson reiterated that PAS is a rare but serious condition in which the placenta invades the uterine wall, potentially causing heavy bleeding at birth. They noted that current data place PAS’s incidence between 1 in 300 and 1 in 2,000 pregnancies, with rising trends. Early identification through scans and follow-up imaging, plus care from specialist teams, can improve outcomes for both mother and baby. The updated guidelines are anticipated later this year.
NHS England has not given a direct response to these concerns. Professor Donald Peebles, national clinical director for maternity, emphasised that while PAS is rare, its dangers warrant early risk identification, especially for women with prior Caesarean sections. Maternity teams are trained to spot warning signs and refer high-risk patients to specialist NHS centres when needed.
If you’re concerned about PAS, sharing experiences or questions in the comments can help start a broader conversation about how we detect and manage this condition more effectively. Do you think the NHS should implement universal PAS screening for at-risk groups, or would targeted screening at higher-risk hospitals be more practical? And how can we balance patient reassurance with timely, aggressive diagnosis in the early stages of pregnancy? Your thoughts matter.
