The MASIC Foundation at 10: A decade of change for childbirth injuries

This year marks the 10th anniversary of The MASIC Foundation, a charity set up with a mission to raise awareness, improve maternity care, challenge stigma and ensure women affected by childbirth injuries are heard. 10 years is a milestone that deserves not only celebration but reflection.  

MASIC has transformed the landscape for women living with severe childbirth injuries, particularly obstetric anal sphincter injuries (OASI), helping thousands of women break the silence surrounding a devastating and often overlooked form of birth trauma.  

At Leigh Day, we are enormously proud to have supported MASIC from the very beginning. We played a key role in helping establish the charity and have since worked with MASIC throughout its journey to today. 

Breaking the silence around OASI and childbirth injuries  

When MASIC was founded, severe perineal trauma remained one of the most hidden areas of women's health. Women experiencing anal incontinence, chronic pain, sexual dysfunction and psychological trauma after childbirth often suffered alone, embarrassed to speak about symptoms that profoundly impacted their lives.  

MASIC changed that.  

As the UK's only charity dedicated specifically to supporting women who have experienced OASI, MASIC has created a community where women are believed, supported and empowered. The charity's work has helped bring maternal birth injuries into public discourse and onto the national healthcare agenda.  

Its achievements over the past decade have been extraordinary. Through support groups, educational events, webinars, policy work and advocacy, MASIC has ensured that the experiences of injured women are no longer ignored.   

We are proud to work with the incredible Professor Michael Keighley, who started the charity, and the amazing women who have bravely spoken out about their injuries to increase awareness as champions of the charity. Without these brave women and our clients, there would not be the level of awareness there is today. 

One particularly important example was our involvement in events examining the long-term consequences of perineal injury, including the impact of menopause on women living with childbirth injuries. These discussions helped shine a light on the fact that birth injuries are not short-term complications but can affect women throughout their lives.  

Sanja Strkljevic, partner in our medical negligence team, has worked closely with MASIC and helped connect women with support, regardless of whether they have a potential legal claim.

The impact of the OASI Care Bundle on maternity care 

Obstetric anal sphincter injuries (OASI) are severe third- and fourth-degree tears sustained during childbirth that can cause long-term physical and psychological harm. 

One of the most significant developments during MASIC's tenure is the introduction and national roll-out of the OASI Care Bundle, a programme aimed at reducing severe perineal tears and improving outcomes for mothers. It was developed through a multidisciplinary collaboration involving clinicians, professional bodies and women's groups. 

The Care Bundle was introduced after concerns over the rising rates of OASI and the inconsistencies in prevention, diagnosis and treatment. It promotes evidence-based measures including antenatal information, manual perineal protection during birth, appropriate use of episiotomy and careful examination after delivery.  

MASIC has been instrumental in promoting awareness of OASI and ensuring that women’s lived experiences remain central to the conversation. Through its educational work and advocacy, the charity has helped drive improvements that will hopefully prevent future generations from suffering avoidable injuries.

The true cost of perineal tears  

The financial costs associated with severe perineal trauma are substantial, but the human costs are immeasurable.  

Women living with undiagnosed or poorly repaired third- and fourth-degree tears often require extensive medical treatment, physiotherapy, psychological support, colorectal interventions and, in some cases, further surgery.  

Yet the consequences extend far beyond healthcare expenditure.  

Research and surveys have highlighted the devastating effect severe birth injuries can have on relationships, parenting and mental health. Women frequently report difficulties bonding with their babies, loss of confidence, depression, isolation and profound impacts on intimate relationships during the postnatal period and beyond. In some cases, women decide against having further children because of their experiences.   

These are not merely physical injuries. They can reshape entire families.

At Leigh Day, we regularly meet women whose careers have been interrupted, whose family lives have been altered and whose mental wellbeing has been severely affected because a preventable injury was missed, misdiagnosed or inadequately treated.  

Leading the way in childbirth injury litigation 

Over the past decade, Leigh Day has established itself as one of the leading legal teams representing women affected by birth negligence. Our lawyers have represented hundreds of women who have suffered avoidable harm following childbirth injuries, including: 

• Missed diagnosis of third- and fourth-degree tears 
• Inadequate repair of severe tears 
• Delays in referral for specialist treatment 
• Failure to recognise symptoms of anal sphincter injury 
• Failure to inform women of risks and treatment options  

While compensation can never undo the harm suffered, litigation plays a vital role in securing access to treatment, rehabilitation and financial security. Equally importantly, it can expose systemic failings and drive improvements in maternity care.

Alongside these reported cases, Sanja Strkljevic, Suzanne White, Despina Kavadas, Emmalene Bushnell, Brendan Hope, Kelly Lawford, Lauren Tully, Julia Reynolds, Angharad Vaughan and colleagues across Leigh Day's clinical negligence team have supported numerous women affected by perineal trauma, forceps-related injuries, fistula formation and failures in postnatal diagnosis and treatment. We have also acted for many professional women who have suffered appalling OASI injuries, which have impacted their future career development and resulted in very high settlements. 

Many of these cases settle confidentially, but collectively they reveal recurring failures in maternity care and reinforce the need for better prevention, diagnosis and support.

Looking ahead  

As MASIC celebrates its first decade, it is impossible not to reflect on how much has changed. Issues that were once hidden behind embarrassment and stigma are now being discussed by policymakers, healthcare professionals and the public. MASIC has been at the heart of that transformation. Its founders, volunteers, advocates and supporters have changed countless lives by pushing a hidden issue into a recognised women's health priority.  

At Leigh Day, we are proud to have been part of that journey from the outset. Yet there remains much work to do. Too many women still report feeling dismissed when they raise concerns. Too many injuries continue to be missed. Too many women are left to believe they are alone.  

We remain committed to supporting MASIC, championing women's voices and fighting for those whose lives have been changed by avoidable childbirth injuries. Together, we will continue to help women find their voice after birth trauma, challenge complacency and fight for safer maternity care and better outcomes for women and families across the UK.  

As MASIC celebrates its first decade, we celebrate not only the charity's achievements but the thousands of women who have spoken out, demanded better care and helped create lasting change. Here's to the next 10 years.