A bold, urgent warning: many pregnancies still hinge on a diagnosis that could save mothers and babies, yet too many accounts reveal people falling through the cracks. This is the story of Amisha Adhia, whose five NHS hospitals missed a rare but potentially deadly pregnancy complication, and who has launched a nationwide campaign to push the NHS to improve how placenta accreta spectrum (PAS) is identified and managed.
What is placenta accreta spectrum? It’s a condition where the placenta embeds too deeply into the wall of the uterus, making it hard to separate after birth. This risk grows for women who have had a prior cesarean section or who underwent IVF. If PAS isn’t spotted before labor begins, it can lead to emergency hysterectomy or life-threatening hemorrhage for the mother.
The NHS estimates PAS affects between 1 in 300 and 1 in 2,000 pregnancies, but specialists warn that the at‑risk population is expanding. More babies in England are being born by C-section (about 45%) than vaginal birth (roughly 44%), a shift that may raise the number of PAS cases—though exact figures aren’t tracked nationally.
Adhia, now 36, formed the Action for Accreta campaign with her husband, Nik. She recounts how several London hospitals told her she lacked PAS, only for Dr. Chineze Otigbah, a consultant obstetrician, to confirm the diagnosis. Her baby daughter Ishaani was delivered last September at Queen’s Hospital in Romford under Dr. Otigbah’s care. The discovery mattered: Adhia received appropriate treatment just in time, after a perilous pregnancy where she was told her risk was negligible because her placenta was positioned high.
“I’m alive today because Dr. Otigbah saw the danger and acted,” Adhia says. She describes being reassured into danger and feeling unheard, overwhelmed by the sense that she was carrying a condition that could have killed both mother and child.
Her account aligns with the voices of dozens of others. After sharing her story online, around 40 individuals who experienced undiagnosed PAS during pregnancy or labor reached out to the couple. There are currently no national figures tracking PAS incidence or outcomes in the NHS, and even the annual MBBRACE-UK maternal health report omits detailed PAS data. By contrast, studies from the United States and Israel suggest prevalence could be as high as about 1 in 111 pregnancies.
Eight maternal and baby health groups back the campaign, including Birthrights and the Birth Trauma Association. Tommy’s and Sands joined with a separate statement praising the initiative for drawing attention to gaps in awareness, surveillance, and learning about serious pregnancy complications.
Official guidance from the Royal College of Obstetricians and Gynaecologists (RCOG) acknowledges that placenta accreta and placenta praevia—both associated with heavy bleeding—carry substantial maternal and neonatal morbidity and mortality. RCOG notes that the rates of PAS are increasing, driven by higher cesarean rates, increasing maternal age, and broader use of assisted reproductive technologies, and that early identification through pregnancy scans and follow-up imaging is crucial for planning care with appropriate specialists.
The Adhias recently provided evidence to Valerie Amos’s inquiry into maternity care in England, prompted by the health secretary’s request. They urged recommendations to improve PAS identification within the NHS. Obstetric experts like Dr. Otigbah emphasize that while PAS risk factors (C-sections and IVF) have risen, some hospitals still lack PAS specialists, allowing subtle warning signs to be missed.
The couple also urged the RCOG to update its guidance to address diagnosing and managing atypical PAS, which is what Amisha experienced. An RCOG spokesperson reaffirmed that PAS is rare but can be life‑threatening, and stressed that early detection through scans and targeted follow-up care improves outcomes, with updated guidelines expected later this year.
NHS England has not given a direct comment on the concerns. Professor Donald Peebles, the national clinical director for maternity, underscored that PAS is rare but dangerous when it occurs, and highlighted the importance of early risk identification for women with prior C-sections. He added that maternity teams are trained to spot warning signs and to refer patients to specialist NHS centers when needed.
So why does this matter right now? Because a preventable oversight in diagnosis can end with devastating consequences. And this is where the debate often intensifies: should the NHS standardize PAS screening across all hospitals, even those without dedicated PAS teams, to ensure every high-risk pregnancy receives early, precise assessment?
If you’re curious about PAS and the state of maternity care enhancements, you’re not alone. What would you prioritize: universal PAS screening protocols, more PAS specialists in every hospital, or better patient advocacy and transparency about risks? Share your thoughts in the comments and tell us where you stand.
