MPs criticize failure to tackle ‘glaring’ racial inequalities in UK maternal health

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Ministers have failed to tackle “appalling” and “shocking” racial disparities in maternal health despite repeated promises, MPs have said, as they seek new targets to end inequalities.

In an alarming report, the women and equalities committee said maternal death rates in deprived areas were rising, with women in the poorest areas around two and a half times more likely to die in childbirth than those in the wealthiest areas.

Black women are still nearly four times more likely to die in childbirth than white women, the report says, and too many black women receive “substandard” treatment. The government and NHS leaders have “forgotten the extent to which racism plays a role”, he says.

It comes after Kemi Badenoch, the equality minister, admitted on Monday that less than half of the measures set out in the government’s plan to tackle racial and community inequality had been leveled up.

In February last year, the Guardian revealed how radical action was needed to tackle “huge” racial health inequalities, after a report was released which concluded that there were “massive” and “widespread” inequalities in all aspect of health care harming the health of millions of patients.

Racism, racial discrimination, barriers to accessing healthcare and the burdensome collection of ethnicity data have had a “negative impact” on the health of black, Asian and minority ethnic people for decades, according to the review, commissioned by the NHS Race and Health Observatory. But more than a year later, MPs say there has been “a lot of talk and little action”.

The committee found a government taskforce set up to tackle disparities in maternity care – announced nine days after the Guardian’s report – met three times. The last time it met was nine months ago, in July 2022. Other government measures have proven to be “inadequate”, the report says.

The lack of action was “absolutely disgraceful”, committee chairwoman Caroline Nokes said. “NHS births are some of the safest in the world and yet we see shocking variations in maternal deaths,” she said. “Surprisingly, black women are almost four times more likely to die from childbirth than white women.”

Health leaders and campaigners said they were sorry but not surprised by the MPs’ results. “We are tired of this issue being a talking point – we are ready for tangible action,” said Dr Habib Naqvi, chief executive of the NHS Race and Health Observatory, an independent specialist group.

“The dire outcomes black women face as a result of racial discrimination in maternity care must be prioritized and addressed as a matter of urgency. The evidence clearly shows that black and other ethnic minority women are often paying with their lives for inaction on racial bias in health care,” said Naqvi.

“It is unacceptable that, today in 2023, these women are subject to a higher risk of dying during pregnancy or childbirth, and should not have higher rates of stillbirth or neonatal death compared to their white counterparts.”

Janaki Mahadevan and Shanthi Gunesekera, co-chief executives of the charity Birthrights, called the committee’s report “deeply concerning”.

They said: “How many more reports or statistics do we need to see about the racism in the structures, cultures and practices governing maternity care in the UK before serious and meaningful action is taken?”

Black and ethnic minority mothers were still too often ignored or dismissed, they said. “These racial microaggressions and stereotyping, failure to recognize serious medical conditions because of skin color, and disrespect for culture and religion, and the resulting inequities are no surprise.”

The committee said a target was needed to close the gap between black women and other ethnic minority women and white women, and the associated gap between those living in the most and least deprived areas.

Among their recommendations, MPs called on Health Education England to lead a co-ordinated review involving the Royal College of Midwives and others “to ensure that the training curricula and continuing professional development requirements for all maternity staff learn evidence-based about maternal health disparities, their possible causes and how to provide culturally competent, personalized and evidence-based care.”

The committee also called for “continuity of carer” for patients – which it said was difficult at present “due to severe staff shortages across maternity services”.

MPs said a fully staffed, properly funded maternity workforce was “fundamental to providing safe, personalized care for pregnant women and new mothers” and called on ministers to commit to an annual increase of up to £350m d ‘maternity units.

Better data was also needed, they said, warning that black women were “regularly under-represented in research or data and therefore in policy-making” and that ethnicity data held by trusts was “incomplete or inaccurate”. .

Nokes said: “We cannot allow these women to remain invisible to the systems that are meant to serve them. We also fear that the government and the NHS have not fully understood that racism plays a central role in the complex causes underlying the differences, and that ending it is part of the solution.”

Laura Seebohm, chief executive of the Maternal Mental Health Alliance, said: “Persistent inequalities in maternity care remain a matter of concern. Every woman, child and family has the right to receive high-quality, compassionate care during and after pregnancy. The human and economic consequences of failing to provide this are significant, making it imperative that these differences in maternal experiences and outcomes are addressed.”

The NHS said it was “committed to ensuring every woman receives quality care” and had made £6.8m available to help local health systems reduce health inequalities.

A spokesman admitted there was “more to do” and said the service would review the committee’s recommendations.

A Department of Health and Social Care spokesman said: “While the NHS is already one of the safest places in the world to give birth, we are absolutely clear that we must ensure maternity care is of the same high standard , regardless of race.

“We have invested £165m from 2021 to grow the maternity workforce and are promoting careers in midwifery with an extra 3,650 training places a year, and all local NHS maternity systems have a plan in place to tackle with variations at the local level.

“Minister Maria Caulfield is today chairing the maternity disparities task force – a group of mothers, clinicians and key organizations – to focus on how we can eradicate inequalities and improve maternity outcomes for all mothers.”

On Monday, Badenoch admitted that only 32 of the 74 measures in the Inclusive Britain strategy published just over a year ago had been completed.

The Black Equity Organisation, an independent group, said that it had to be accepted that structural racism exists, and until then the Ministers would continue to insist on the edge of the problem.

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