Outcomes in Maternal Care, Nationally and Locally

Maternal care is a crucial provision by health services, and it is thus important that it is up to high standards for whoever needs to access it. Nationally, the conversation surrounding racial disparities in maternal care outcomes has raised concerns about these standards and has therefore begun a discussion as to what can be done to mitigate not just disparities but also instances of poor outcomes.

The 2021 MBRRACE report helpfully covers what the main issues are in maternal care in broad statistical findings. Whilst there was however as decrease in maternal death rate nationally between 2014-16 (years covered in the 2018 MBRRACE report) and 2017-19, that decrease was not statistically significant (I.e.it is unknown whether it was due to actual improvement in maternity services or simply chance). Thus, it makes sense that “The UK Government Health and Social Care Committee “rated progress against the ambition in England to reduce maternal mortality by 50% by 2025 as inadequate”. Maternal deaths as of these findings are at 8.8 per 100,000. Famously, the 2018 MBRRACE report elucidated racial disparities both in maternal and perinatal deaths. As of 2014-16 Asian women were twice as likely to do die in the perinatal period than white women and for black women it was five times more likely.

The Birthrights “Inquiry into racial injustice and human rights in UK maternity care” explored numerous incidents of poor outcomes in maternal care, particularly for women of ethnic minority backgrounds arguing that systemic racism was at least in part a cause of the disparities. Many examples being due to racial insensitivity, namely a “failure to recognise jaundice in a black baby”. Other instances involved outright racially charged remarks such as a Muslim waiting for Halal milk overhearing “people like [her]” had caused problems like this before. There have also been other incidents  for example incidents in which women were not believed when reporting contractions. Whilst these specific incidents are from case studies, it is clear that maternal care nationally needs to generate consistently positive outcomes for individuals using such services no matter their ethnic background.

We are familiar with the issues nationally, which is why we want to identify the issues, causes, and strategies for improvement that are representative and applicable to our area. Healthwatches across our North East London want to ensure people are offered the best experience when using maternity services; which is why we are undertaking a project on maternity services (Click on these links to find out more about your local Healthwatch in Barking and Dagenham, Hackney, Havering, Newham, Redbridge, Tower Hamlets and Waltham Forest).

East London has the highest birth rate in the UK. Our health and care services must fully support this growth and continue to ensure the best possible outcomes for mothers and babies. In particular, we are looking to understand the experiences of patient’s from minority or marginalised groups when accessing and experiencing maternity services.

It is of great benefit to understand if these disparities exist for users of maternity services in our area along with gaining a more detailed picture of common themes between the national and local situations. That’s why your stories are so valuable.

Your feedback will help develop a strategy that will help improve maternity services in our local area. To this end we are using a survey to get local people using maternity services to inform us of their good and bad experiences so we can help influence positive change.

Click here to take part in the survey