What’s in store for maternity care: reflections on the King’s Speech 

With a new government and the first Labour King’s Speech in 14 years, what have we learnt about what’s in store for maternity care? 

The positives

First the positive; to see the language of “autonomy” and “rights” expressed clearly in the Mental Health Bill is a very welcome step. Acknowledgement that improvement in care is underpinned by a culture where everyone is “treated with dignity and respect” is core to the human rights framework that drives Birthrights mission. This coupled with a clear intention to “shift the balance of power from the system to the patient, putting service users at the centre of decisions about their own care”, provides hope that the Government understands person-centred and rights-based care is not an add on, but core to improving the NHS.  

As we know, rights mean very little if they cannot be accessed by everyone. The suggestion that the NHS must be “a service for all, providing care on the basis of need regardless of the ability to pay”, is a glimmer of hope. There is also some relief from frontline healthcare professionals as the Government has sought to dampen efforts to limit trade union action and more broadly focus on greater protections for workers. 

Questions remain

However, as with any legislative agenda, the detail is what matters. Words and intention are hollow if they are not backed by substantive and properly funded action. Questions remain: 

• Does a service for all have any exceptions? 

• Does providing care on the basis of need, mean the removal of charging for those with no recourse to public funds? 

• Do autonomy and rights; dignity and respect really extend to everyone? 

• Do protections for workers mean overhauling regulatory bodies, stamping out bullying and racism in the workplace and tackling blame and cover-up culture?  

There is no explicit mention of maternity care throughout the King’s Speech. While this is not necessarily surprising, it is disappointing that we are yet to see a ministerial role dedicated to improving maternal outcomes and addressing the persistent disparities in experiences and outcomes. The Equality (Race and Disability) Bill is very much focused on tackling inequity in pay and employment, which while absolutely important, perhaps misses the opportunity to look more broadly at the deep, insidious and pervasive systemic racism and injustice that operates to oppress, marginalise and silence Black, Brown, racially minoritised, disabled, neurodiverse, LGBTQI+, gender queer, migrant, and detained people. 

We are at crisis point for maternity services and this detail matters.  

What we need now

What we need now is to see from government how these words and ambitions translate to action when we know that we have: 

• The right to life 

• The right to be treated with dignity and respect 

• The right to make informed decisions about our body and our care 

• The right to choose where we give birth, how we give birth, and who is with us when we give birth. 

• The right to equality, to be able to access these rights free from discrimination 

But we also know that these rights are far from accessible to all.  

We are hopeful that change can happen, but we need government to commit to and invest in developing the systems, institutions and individuals needed to proactively protect the fundamental rights of everyone using maternity care that will lead to the change we all want to see.