Neonatology Expert Witnesses: How Do They Support UK Medical Negligence Cases?
MBRRACE-UK publishes figures on baby deaths every year, and the June 2026 report, covering births in 2024, shows things moving the right way. Stillbirths and neonatal deaths combined came to 4.77 per 1,000 births, which is 21% lower than in 2013. Neonatal deaths on their own fell compared with 2023, although the rate differs more from one hospital to another than stillbirth does. The report also warns against reading too much into a single unit’s figures, since the busiest neonatal units care for the sickest and most premature babies.
The reasons babies die in the first weeks have not changed much. Congenital anomalies, problems with the brain or nervous system, extreme prematurity, heart or lung complications and infection still head the list. Not every one of those deaths involves negligence, and a large part of the work in these claims is sorting out which ones do.
That is where a neonatology expert witness comes in. A neonatal death solicitor can organise the records and run the claim, but whether a baby’s care in the first hours of life was reasonable, and whether it changed the outcome, is a question for someone who has worked on a neonatal unit.
Who is a neonatology expert witness?
Walk onto a neonatal unit and the doctors you will meet are neonatologists, paediatricians who trained further to look after babies born too early or born unwell. Some of their patients weigh well under a kilogram. When one of them is instructed as an expert witness, the court wants their view on a baby’s care after delivery and on whether that care made any difference. Most are on the GMC Specialist Register and still treat patients, which matters because practice on a neonatal unit keeps changing.
Obstetricians and midwives cover pregnancy and labour, so a claim about a single baby often ends up with several experts.
Why causation is usually the hard part
A claim for neonatal death negligence takes two steps. The first is showing that care fell below a reasonable standard. The second, showing that it caused the death, is where claims tend to stall. Picture a baby born at term who starts grunting and feeds badly a few hours after delivery, with antibiotics not given until much later. That delay looks bad on paper, but the court will want to know whether giving them earlier would probably have saved the baby, and nobody can answer that by reading the chart alone.
Some babies with infection deteriorate so fast that even prompt treatment would not have changed things. Others would very likely have survived if the first signs had been picked up. Telling those two situations apart is the neonatologist’s job, and the reasoning behind it often decides the case.
What the expert reads
The expert needs the complete record, not a summary. The documents that tend to matter most are:
Labour and delivery notes, including fetal heart rate traces
Cord blood gas results and Apgar scores
Resuscitation records from the first minutes
Neonatal unit charts, observations and prescriptions
The post-mortem report, where one was carried out
Any investigation report the hospital produced
Because a ninety-minute delay in this profession can alter what a reasonable clinician would have done, the expert creates a timeline from these, usually hour by hour. Cooling treatment is supposed to start within six hours for babies who may have been oxygen deprived at birth, thus when it started can be the most important information in the file. When one is available, a post-mortem frequently modifies the analysis, and most neonatologists prefer to watch it before making a decision.
A hospital’s own investigation report is worth reading, but it is not independent expert evidence and should not be treated as such.
Where they fit alongside other experts
One report rarely carries a neonatal death claim. The obstetric and midwifery experts deal with labour and delivery, the neonatologist picks up from the moment the baby is born, and a good share of the arguments happen in the gap between those two accounts: when did the baby first look unwell, and who knew? Add a pathologist if the cause of death is disputed and a pediatric neuroradiologist if the brain scans matter. Reports written without sight of each other tend to disagree on timings, so it pays to give every expert the same timeline from the start.
Choosing a neonatology expert
A 25-week baby and a term baby with an infection raise quite different questions, so the expert’s sub-specialty needs to match the problem. They should also be a working consultant, because someone who left the unit a few years ago may be describing practice that has since moved on. It’s worth asking how often they have given evidence and how those reports held up, and reading a sample if they will share one. Bereaved parents sometimes read these reports too, so the writing has to be clear and kind as well as accurate.
Process and timing
Time limits generally apply, usually three years, and neonatal death claim lawyers can confirm how they work in a particular case. Instructing an expert early helps a firm decide whether a claim is worth pursuing before a family has spent months waiting for an answer.
Expert reports in these claims follow CPR Part 35, so the expert’s duty is to the court, not to the family or the firm. The claim usually goes through the pre-action protocol first, and the hospital’s response can arrive with expert evidence of its own. If both sides have a neonatologist, the two normally sit down together and write up where they agree and where they do not, and that short document often shapes what happens next.
If you are a neonatologist considering expert work
You are used to making decisions in real time with incomplete information. As an expert, you judge those decisions afterwards, with the full record in front of you, so you will need to guard against hindsight. The question is always what a reasonable neonatologist would have done at the time. You will also need to write for readers who are not doctors, and in some cases for bereaved parents.
Expert Witness Gateway lists neonatology specialists by experience and sub-specialty, which helps neonatal death compensation lawyers find someone whose practice fits the case in front of them.