It’s no secret that maternity care in England is in real crisis. A recent 174-page report reiterated what many – families, midwives, legal experts – have known for years: too many women and their babies are frequently experiencing harm. Baroness Valerie Amos, chair of the National Maternity and Neonatal Investigation which published the report, called for an immediate overhaul of the maternity system as “it is not fit for the now, and it is not fit for the future”. Issues repeatedly flagged during the investigation included women and families not being listened to; racism and discrimination; and services not being set up to support women’s choices. In the very worst cases, women and babies died, while many others have been left with long-lasting injuries and trauma. As conversations around the broken maternity system continue to swirl, Zara Ishfaq is sharing her story to try and raise awareness of birth injuries, particularly among women of South Asian heritage. Previous research from birth injury charity The MASIC Foundation found that around one in 20 first-time mums suffer an obstetric anal sphincter injury (OASI) – or severe tearing – during childbirth. However, studies have also found women of Asian heritage are up to nine times more likely to suffer an OASI during vaginal birth than white women. Zara Ishfaq Zara was left with a devastating birth injury which remained undiagnosed for two years. She’s been left with ongoing bowel complications as a result, including needing to have a stoma fitted in 2025. She’s, sadly, not alone in her plight. New NHS figures shared by The Guardian show the rate of women experiencing the most serious type of tear during childbirth is at the highest since monitoring began in 2020. Zara suffered a life-changing birth injury after a three-day labour in December 2021 which resulted in her baby’s head becoming stuck. In the end, baby Aariz – her first baby – was delivered by forceps weighing 7.7 pounds. (Use of forceps has been linked to higher rates of anal sphincter injuries in birthing parents.) The mum, from London, suffered a serious post-delivery bleed, losing around two litres of blood. She also experienced a perineal tear – a common issue for vaginal births. Roughly nine in 10 first-time mothers who give birth vaginally will have some sort of tear, graze or episiotomy, according to the NHS. For most women, these tears are minor (usually called a “first-degree tear”) and heal quickly. A second-degree tear will typically require stitches, while a third- and fourth-degree tear may be deeper and therefore impact the anal sphincter muscle. These injuries are known as OASI and typically need repair surgery. It can trigger bowel incontinence, which – in new mothers – can impact many aspects of life, from sex and work to socialising and bonding with their baby. Zara’s tear was underestimated, and despite complaining of symptoms and attending medical appointments it took more than two years before she received a proper diagnosis, during which time her complications worsened. “Over time my symptoms became worse and had a greater effect on my life and also my ability to bond with my baby,” she said. “While my friends were meeting in the park and attending baby groups, I was barely able to leave the house. I struggled on, but the situation was dire.” She began to experience changing bowel habits and by the following June, was going to the toilet more frequently and leaking, but was sent home with advice to do pelvic floor exercises. In December that year, she complained of continuing symptoms and needing to wear an incontinence pad. But it wasn’t until May 2024 that she finally received confirmation that the severity of the perineal tear she sustained at birth had been underestimated, and she would require an operation to try and repair the damage. A year later she underwent surgery, but was left with ongoing bowel complications. Zara has since had another baby, Elayna, but sadly the pregnancy wasn’t straightforward. “My second pregnancy was affected because of my symptoms,” she explained. “I suffered with hyperemesis [gravidarum] – serious sickness. Because of my injuries it was coming out of both ends. I suffered with infections and at one point developed sepsis.” She continued: “I feel so blessed and lucky to have my children and they’re adorable. However, that I had to go through the experience I did will always upset me. “It’s not just the physical injuries that affect you, it’s the psychological toll of having a reduced quality of life. Too many women are suffering unnecessarily and more needs to be done to improve maternity care, but also break the taboo around birth injuries to mums.” The parent is due to share her story at legal firm Irwin Mitchell’s South Asian Maternal Health Conference next spring, which focuses on tackling maternal health inequalities. “The solution starts with listening to women,” she ended. “If birth injuries are recognised earlier, treated sooner, and taken seriously, fewer women will have to live for years with preventable suffering.” Related... Glamour UK Slammed Over 'Tone Deaf' Post On What To Wear To 'Feel Cute' Giving Birth Medical Expert Reveals What Happens During A C-Section Birth I Study Maternal Health – And It's Exactly Why I'm Afraid To Give Birth