Government urged to end pregnancy safety inequality

A report from the Joint Committee on Human Rights (JCHR) today calls for urgent Government action to make sure that Black people have the same protection for their human rights as white people in the UK, highlighting the unacceptable difference in maternal mortality rates as a key example of the inequality that needs to be tackled.

12 November 2020 

The new research was commissioned after the UK Government launched a Commission on Race and Ethnic Disparities this summer, and a key finding was that more than 60% of Black people surveyed don’t believe their health is equally protected by the NHS compared to white people – with a prime example being the fact that Black mothers in the UK are 5 times more likely to die in childbirth.

Despite mothers being more likely to give birth later in life and have underlying health conditions, which can raise the risks, maternal mortality rates in the UK have fallen since 2010. However, data from the MBRRACE partnership highlights persistent and significant differences:

  • 7 in 100,000 white mothers die in childbirth
  • 13 in 100,000 Asian mothers die in childbirth
  • 23 in 100,000 mixed ethnicity mothers die in childbirth
  • 38 in 100,000 Black mothers die in childbirth

We’re determined to change these unacceptable statistics, as part of the Tommy’s mission to make the UK the safest place in the world to give birth. The reasons for the dramatically different death rates are still not fully understood, and the NHS acknowledges the disparity but has no target to end it; we believe, as the JHCR report states, this must be rectified.

“This inequality has to change; everyone is entitled to the best care for themselves and their baby. The NHS must take urgent action to understand why some Black mothers aren’t having the safe pregnancies and births they should – and put in place things we already know make a big difference to the health of mothers and babies, such as having one midwife throughout their journey to parenthood, with ongoing risk assessments and frequent check-ups if needed.” - Tommy’s CEO Jane Brewin

Why it’s happening

Research shows the racial disparity in pregnancy outcomes is not necessarily down to biological factors but a number of issues, including socio-economic factors that mean Black women are more likely to live in poverty and experience deprivation, differences in the availability of and access to good quality maternity care across the UK, and a level of bias within the healthcare system that makes it harder to identify women at risk and deliver the specific personalised care they need.

Our National Centre for Maternity Improvement exists solely to work with and within the NHS to bring about changes in care that will make pregnancy safer and save babies’ lives. As the largest charity in the UK funding pregnancy research, we also work with other professional bodies such as the Royal College of Obstetricians and Gynaecologists and Royal College of Midwives, as well as important decision-makers like Public Health England, the Department for Health and Social Care, and campaign with relevant partners to improve maternity care.

“I am still not confident that we know why there is an inequality in health outcomes between a black woman and a white woman. We have plausible explanations and the evidence on comorbidities is compelling, but there is something more.” - Professor Jacqueline Dunkley-Bent

What we’re doing

Our research is designed to target ‘high risk’ women and improve their chances of having a safe pregnancy and a healthy baby; this means women - often from Black, Asian and other minority ethnic backgrounds - who are more likely to experience pregnancy complications, premature birth or stillbirth. Across the UK, our research centres and specialist clinics work solely with these women to design care and treatment to make their pregnancy safer.

After we’ve found out what works in our labs and clinics, we then work with the NHS and policy makers to try and change and improve care across the health system – for example, by producing the Saving Babies Lives Care Bundle to reduce stillbirth, which affects 1 in 250 pregnancies in the UK and is more common among Black women.

“Unless all ethnic communities are included in research, the medical profession will never be able to develop culturally competent diagnostic tests and services, and therefore can’t deliver true equity in healthcare.” - Professor Gurch Randhawa

We develop our pregnancy information resources and campaigns with input from people of different backgrounds, to make sure they resonate with all those who need them. We also work to reach people who are likely to need information and support but may not seek us out; for example, our Your Baby’s Mum tool for maternal wellbeing can benefit all mums, but we know that Black women can face more barriers getting help so we use our limited funds to actively promote it to them.

How you can help

We’re proud to be working with the tireless campaigners at Five X More to tackle this inequality, and you can get involved by signing the petition and sharing a #fivexmore selfie to show your support. The campaign has also developed 6 steps to help empower and protect mums-to-be so we can put an end to these shocking statistics:

  1. SPEAK UP – If you feel like something isn’t right, make sure you speak to a medical professional and don’t stay silent.
  2. FIND AN ADVOCATE – This could be your partner, a family member or a trusted friend that can speak on your behalf if need be.
  3. SEEK A SECOND OPINION – You’re allowed to ask for a second opinion of another medical professional if you feel you need to.
  4. TRUST YOUR GUT FEELING – And speak up. Your gut feelings are almost always right. Don’t ignore them. You know your body better than anyone.
  5. DO YOUR RESEARCH – Use trusted sources such as Tommy’s Pregnancy Hub, NHS.uk, nice.org.uk and patient.info to learn about pregnancy and labour.
  6. DOCUMENT EVERYTHING – Make sure any treatment or medication you are given or refused is written down in your maternity notes by your doctor or midwife stating their name and reason why. Go a step further and keep your own personal journal and write down all the information for your own cross reference.

Find out more about the campaign at www.fivexmore.com.

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