Why her analyses matter
Sarah Hawkins is not a clinician, a statistician or a lawyer. She is a lay reader with specific relevant experience: she has been through a twin pregnancy with the complications that twin pregnancies can bring. That experiential fluency with the obstetric context is precisely what the Crown’s trial presentation assumed the jury would lack, and what independent obstetric experts were not extensively called to explain.
Her two long-form pieces hosted on this site — the open letter from a twin mother and the triplets-to-singletons referral-pathway essay — walk the reader through the obstetric evidence that the indicted babies’ antenatal histories actually show, and the specific referral decisions that shaped where and how those babies were cared for.
What her work establishes
- The multiple-pregnancy cohort that made up a disproportionate share of the Letby indictment (twins, triplets) is a medically distinct and higher-risk population than singleton deliveries. Their baseline trajectories are not the same as a general NICU baseline.
- Specific conditions affecting these pregnancies — selective intrauterine growth restriction (sIUGR), twin-to-twin transfusion syndrome (TTTS), antiphospholipid syndrome (APS) — carry specific post-natal risk profiles that were not walked through at trial in the detail a proper obstetric expert would have done.
- Referral decisions between the Countess of Chester and Liverpool Women’s Hospital during 2014–2016 routed high-acuity multiple-pregnancy cases into a Level 2 unit that, on contemporaneous UK neonatal-network guidance, should have been transferring out.
- When the indicted cases are read as a multiple-pregnancy high-risk cohort cared for in a unit that was operationally stretched, the pattern reads very differently from the Crown’s framing of deliberate harm.
Why lay writing of this quality is rare and load-bearing
Public commentary on high-profile criminal cases is usually dominated by either specialists speaking in their professional idiom or by campaigners speaking in advocacy idiom. Hawkins’s writing does neither. It works through the primary material at the level of detail a careful reader can follow, citing sources throughout, in an accessible register. That combination — patient, sourced, readable — is uncommon. It is part of why her pieces have been taken seriously by practising obstetricians, neonatologists and statisticians.
Her work sits alongside the Prof. Richard Gill statistical critique in the sense that both apply domain knowledge to reveal gaps in how the trial evidence was framed. Where Gill brings the Leiden statistician’s frame, Hawkins brings the twin-mother’s frame — and on the obstetric strand of the case, the twin-mother’s frame turns out to illuminate a great deal.