The latest MBRRACE report paints a bleak picture of worsening outcomes for all women and birthing people and a failure to address the persistent gap in outcomes for Black and Asian communities.
The data from 2020 to 2022 also exposes severe gaps in care for migrant women and birthing people, highlighting a lack of effective language support and information about the health system that is essential to navigating maternity pathways.
Worsening outcomes
Confirming figures published at the beginning of this year, the report outlines a worrying increase in the maternal mortality rate even when disregarding Covid-related deaths. After more than two decades of recording ethnic disparities in outcome we can also see that a failure to recognise the systemic racism driving inequities continues to lead to Black women being three times as likely and Asian women twice as likely to die as a result of pregnancy and childbirth than white women.
We know that individuals, families and communities have been left with a lifetime of trauma and devastation as a result of the worst possible outcomes presented in these figures. There has never been a more critical time to face up to the realities of systemic racism and take collective action to dismantle it.
That is why we’re calling on the Government to introduce a new SAFE Maternity Care Act to make crystal clear how human rights law applies to all those who manage, deliver and regulate maternity care and ensure Safety, Accountability, Freedom of Choice and Equity are at the core of the maternity system.
Systemic racism, not Broken Bodies
Our report published in 2022 made clear that the driver behind these outcomes is Systemic Racism, not Broken Bodies. It found a multitude of factors contributing to racial disparities, including:
- consistent failure to identify medical conditions due to skin colour,
- racial microaggressions and stereotyping,
- breaches of consent
- a continued centring of whiteness in medical education and practice
- lack of understanding, curiosity and respect for culture and religion
And ultimately the dismissal of the voices of women and birthing people.
The report also documents the additional barriers faced by migrant women and birthing people. Now is the time to take action. We must remove harmful NHS charging rules that deter people from accessing care and force healthcare professionals to act as pseudo-border control officials. Effective interpretation services are vital to ensure women and birthing people can access rights-respecting care and can properly consent to treatment, but are rarely available. We need to end the detention of pregnant women in both the criminal justice and immigration systems.
Call to action
We’re calling on the Government to ensure everyone involved in maternity care upholds human rights for everyone throughout pregnancy, birth and in the postnatal period through the establishment of a new SAFE Maternity Care Act – an act that ensures Safety, Accountability, Freedom of Choice and Equity are at the core of the maternity system.
Person- and human-rights centred care, which listens and responds to the voices of Black women and birthing people must be the starting point of any solution.
Truly individualised and culturally competent care means giving women and birthing people the information they need to make informed decisions about their births, as well as embedding their voices, decisions and experiences throughout training, guidelines, policy and practice as well as legislation.
We know through our work in NHS Trusts that too often, frontline professionals trying to uphold the very best practices for people in their care are faced with unsupportive, under-resourced, bullying, and toxic working environments and blame and cover-up cultures.
We need to take a really hard look at a system which is leaving both women and birthing people and healthcare professionals broken.
We need to make sure that the entire system, from managers, to regulators, to frontline staff understand how human rights law applies and why it is critical to the delivery of safe care.
Find out about our SAFE Maternity Care Act campaign