Response to comments made by NMNI expert advisor on BBC Radio 4 Today
Tuesday 3 November 2026
Our response to comments by Professor Julia Sanders, a midwifery expert advisor in the National Maternity and Neonatal Investigation (NMNI), on BBC Radio 4’s Today programme, 2 November 2026:
We were deeply disturbed by Julia Sanders’ comments on BBC Radio 4 Today, defending the NMNI Review and dismissing the concern that normal birth ideology shaped care at Oxford University Hospitals (OUH).
The NMNI said it did not find the ideology to be widespread in the services it visited, but also that this “should not dismiss the concerns of families”.
But Professor Sanders’ comments did just that.
A reminder about the NMNI’s “families-first” approach
Before we set out our concerns and evidence, we would respectfully remind the NMNI expert advisors and DHSC of their commitment to a families-first approach to the investigation. That commitment should not end with the publication of the reports, particularly when families are raising serious concerns about how their testimonies have been analysed.
It is deeply disappointing that, rather than reaching out to us directly to listen to and understand these concerns, the decision was made to respond publicly on a radio programme, where our concerns were dismissed. This is particularly difficult to accept given that we have previously made numerous efforts to engage directly with the NMNI team about these concerns.
Families who have already experienced unimaginable harm should not have to fight to be heard by an investigation that promised to put them first. Meaningful engagement means listening to families, especially when they raise uncomfortable questions, rather than simply responding to them in the media reactively.
Clear evidence of ‘normal birth’ ideology at OUH
In November 2025, Families Failed by OUH Maternity Services complied a detailed, 40-page report, Systemic Failings Told Through Family Voices, for the NMNI team, drawing on the experiences of more than 700 families harmed by maternity care at OUH, in addition to the hundreds of testimonials on our website.
The evidence could not have been clearer for the NMNI team but we have since been informed that the expert advisors did not even see our report.
On Radio 4, Professor Sanders told a national audience that “we talked to many families”.
Professor Sanders has never contacted or met Families Failed by OUH Maternity Services. She did not attend any of our evidence panels and none of our members spoke to her. She has judged the evidence of Oxford families without ever listening to us, without seeing our report, and, likely, on the basis of AI summaries of our traumatic testimonies.
Our report documented women being denied caesarean sections, including women who had specifically requested them because of concerns about their safety. It described women being subjected to psychological assessments simply for requesting a caesarean birth, and others being pressured into unwanted interventions or refused pain relief during labour.
Women described being told to trust their bodies, having their concerns dismissed, and feeling that achieving a vaginal birth was being prioritised over their safety, their choices and the well-being of their babies.
The existence of a ‘normal birth’ ideology at OUH cannot be denied when multiple mothers have told us that a senior consultant obstetrician tried to talk them out of elective caesareans, telling them they would be ‘proud’ of themselves for having a ‘natural birth’.
In another case, a mother who had undergone an emergency caesarean overheard a midwife telling a colleague that her son was in NICU because she had been "too lazy" to give birth naturally and that she was a "bad mother". In another, a midwife told a mother that having a caesarean would stop her from bonding with her child.
The NMNI’s own report into OUH records a senior leader describing the same pattern:
A senior leader gave an example of how these power relationships manifest in patient relationships citing the example in maternity services where there was a reluctance to accept the 2011 NICE guidelines for caesarean sections on maternal request when they first started working at the Trust in 2019.
“...perhaps I can talk you through my impression of the elective caesarean section bits. Because I think what it evidences headline is a resistance to letting go of professional power.”
"So I think the resistance that I saw...in 2019 to elective caesarean sections, maternal request sections, I should say, was primarily driven by it feeling like an affront to professional expertise.”
The NMNI itself describes the safety concern as a professional belief or culture that steers women “towards or away from particular choices” without balanced information and informed consent.
Denying a woman a caesarean she has asked for is steering her away and OUH had an anti-caesarean policy in place for years. The resistance is there in the words of the Trust’s own staff and what it resisted is what families describe being denied.
For families in our campaign group, being denied elective caesareans and delays in performing emergency caesareans have led to the deaths of babies, brain injuries that have left children disabled, and catastrophic physical harm to mothers.
We can only conclude that either Professor Sanders has not read the detailed evidence submitted to the NMNI by Oxford families, or she has read it and chosen not to believe the women and families who bravely shared their experiences.
We want to ask Professor Sanders directly:
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Why did you dismiss our concerns on a national broadcast, including by saying, “I’m really sorry if they feel that was the case”? What is the “if” doing, when families are telling you evidence was missed?
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When asked about the families’ testimony, why did you tell a national audience that “every piece of evidence was considered”, when we have evidence that this is not the case for Oxford?
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Can you demonstrate that you saw and considered all of the evidence submitted by Oxfordshire families?
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You said “we talked to many families”. To our knowledge, you have not spoken to Oxfordshire families personally; why not speak with the group that submitted extensive evidence?
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You defined normal birth ideology as a belief system that promotes normal birth “beyond safe limits”. The NMNI also counts steering women away from the choices they want. Which definition did you apply to Oxford? Which definition did you apply when you considered national evidence?
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You said Oxford consultants were “professionally affronted at being asked to give women choice”. How is that not evidence of the culture Oxfordshire families described?
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Why did you answer concerns about Oxford by pointing to national caesarean and intervention rates?
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Have you considered that you may be working in a system so shaped by this ideology that it is difficult to see past it and think critically about it?
We would like to make it clear how deeply distressing it is for families who found the courage to share deeply traumatic experiences, and placed trust in the NMNI, are now being confronted with public statements from Professor Sanders that appear to dismiss the very concerns we raised.
The NMNI’s use of AI analysis and its impact
The emerging questions about how artificial intelligence was used to summarise evidence for the NMNI make this even more concerning.
Families who gave evidence at online and in-person meetings were not informed or asked by the NMNI team about the use of AI in analysing their interview transcripts. Families were provided with the following information, none of which refer to AI analysis or AI use: NMNI Family Information Pack and NMNI Privacy Notice.
In October 2025, prior to the family evidence panels, participants received a Family Information Pack. Its FAQs clearly state that the analysis of transcripts will be undertaken by humans:
How will the investigation use/ analyse the evidence gathered in 1:1 interviews and family evidence panels?
Our experienced analysts will gather all the views and experiences shared with us into a database where they can look for common themes, report the range of experiences, and share any ideas that could improve services. Using a database helps us keep track of everything people have said in their own words, so that we can group things that are common between experiences while still understanding what is unique to each person.
The privacy notice issued with that information pack made no mention of artificial intelligence. The NMNI’s final report (July 2026) subsequently describes an AI-assisted approach to analysing the evidence it collected, which it says included transcripts of interviews and evidence panels.
We want to be clear about this. Oxfordshire families who met with Baroness Amos and the NMNI team in October 2025 to provide evidence did NOT consent to their sensitive health data being input into AI systems, or analysed by AI. They were NOT provided with any information about AI use.
For Oxfordshire families this means that our sensitive data has been used without our consent. And this data was processed by NHS England, where the CEO of OUH was seconded to as Deputy CEO at the time.
Asked whether AI contributed to testimonies being missed, Professor Sanders answered “I don’t think it was”, without saying what checks had been made.
On the same programme, Dr Bill Kirkup, who chaired the Morecambe Bay and East Kent inquiries, said “an important strand of evidence has been missed”. The NMNI’s final report records that he stood down as an expert adviser on 22 June 2026 because he could not agree the wording of the conclusions on normal birth ideology.
Families deserve to know whether their testimonies were properly considered and how such significant evidence could have been overlooked.
In conclusion
As a result, we are asking Professor Sanders, Baroness Amos and the NMNI team to read the evidence that families submitted and explain how they reached their conclusions.
Our evidence deserves to be taken seriously and we deserve answers to our questions and concerns. For ease, we have included some extracts from the testimonies on our website which demonstrate OUH’s drive for normal birth below.
We would also respectfully request that Professor Sanders answers the questions set out above, publicly and makes contact with our campaign group of harmed families to apologise personally.
We trusted and believed in the NMNI process given that it was a national investigation but we were failed, once again. We were told by MPs and those in power to sit tight and wait for the results of the NMNI. Again, we were failed.
We repeat our call for a full, independent investigation into maternity and neonatal services at Oxford University Hospitals, with terms of reference developed alongside affected families.
It is increasingly apparent that this needs to be judge-led to ensure that witnesses can be compelled to give evidence.
Families Failed by OUH Maternity Services
2023 birth: "I gave birth to my daughter via a category 1 emergency caesarean section following seven days of latent labour. During that week, I was admitted to Spires and then spent three days on Level 6 awaiting an induction. Induction was presented as the only option, and a caesarean birth was never discussed with me.Induction was presented as the only option, and a caesarean birth was never discussed with me. In the weeks leading up to delivery, I had experienced repeated episodes of reduced fetal movements, and the community midwife had noticed that my bump had stopped growing. Despite raising these concerns, I was refused a growth scan by a consultant. After three days of waiting, I was finally taken to delivery suite for my induction. Over the following 14 hours, I repeatedly asked for a caesarean section. After seven days of labour, with very little sleep and significant physical and emotional exhaustion, I knew I was not in a fit mental or physical state to endure an induced labour. My requests for a caesarean were refused on four separate occasions because there was no "medical reason" to proceed. Eventually, my daughter's heart rate dropped to 30 beats per minute, and I was rushed to theatre for a category 1 emergency caesarean. I am confident that a lot of the trauma associated with the birth could have been avoided if my wishes had been listened to earlier. I had to reach a point of medical emergency before I was taken seriously. The day after giving birth, I requested to speak to the doctor involved in my care. After I requested my notes, I read the documentation from that discussion, and I had been described as being scared of a caesarean and that I lacked understanding. This was particularly distressing because I had spent hours explicitly requesting one. My daughter was born on the 1st centile and was likely growth restricted, yet this had not been recognised or documented at all in my notes."
2018 birth: “When I booked in, I made it very clear that I wanted a c-section and was aware of the NICE guidelines… At every appointment I repeated my request for a c-section… At around 18 weeks I saw a registrar who said they 'didn't really do this here', which really started to ring alarm bells… I saw the consultant midwife who basically offered birth on the birthing suite… she told me I would have to see psychiatry to discuss a c-section… I really needed a plan and it didn't feel that Oxford were going to facilitate this and refer me to another hospital as per NICE guidelines to have a c-section, and in a blind panic I referred myself. In the meantime my psychiatry appointment came through… This was the worst appointment I have ever been to… I was horrified when I received his letter a week later which had documented 'in an ideal world, she would put the baby up for adoption’. I never said this at all. What I said was 'if I had known it would have been this hard (the pregnancy and requesting a c-section) we would have thought about adopting.’… I honestly just felt like a number during antenatal 'care' at the JR and that their agenda for vaginal births and restricting c-sections mentally broke me.”