Read: New taskforce is an opportunity to get to grips with disparities in maternal care

Following a raft of recent statistics which paint an increasingly disturbing picture of health inequality in the UK today, it is welcome news that the Government has committed to tackling a key area where disparities are continuing to grow - maternal care.

The Maternity Disparities Taskforce, set up by the Minister for Patient Safety and Primary Care, Maria Caulfield, and co-chaired by Professor Jacqueline Dunkley-Bent OBE, aims to level up maternity care through a better understanding of the drivers that cause inequality. These are complex but there will be a focus on the social factors linked to poorer health outcomes. As well as this, they will be looking at the ways government can improve the health and wellbeing of women from ethnic minority communities and those living in deprived areas, and their babies.

The Taskforce has been established in the wake of shocking figures that show health inequality across a range of maternity markers. The 2021 Mbrrace report (Saving Lives, Improving Mothers’ Care: Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2017-19) found that black women are more than four times more likely to die in pregnancy or childbirth as white women in the UK, and women from Asian backgrounds almost twice as likely. Analysis in the Lancet has also suggested that the risk of miscarriage for black women is 43% higher than for white women.

Although the stillbirth rate has been reduced by over 35% since 2010 and the neonatal mortality rate by 29%, it’s concerning that there has been so little progress over the last decade and high rates still persist among women from ethnic minorities. Poor outcomes are also a feature of some of our most deprived communities - for example Birmingham has the highest rates of neonatal mortality and stillbirths at 11.4 per 1000, a high number of low birthweight babies - 9.7% in 2018 - and a high prematurity rate.

As with inequality more broadly, the impact goes far beyond the immediate issue. Research has shown that women from all ethnic backgrounds who suffer miscarriage are more vulnerable to long-term health problems such as blood clots, heart disease and depression. A study by the University of Essex also showed that there was a 30% rise in expectant mothers reporting depression during the pandemic, from 17% to 47%, with anxiety rates also increasing from 37% to 60%. Crucially, this research also highlighted the role that social support and the NHS played in protecting their mental health and advocated for more help for women during this time to avoid negative outcomes on them, their babies and on later infant and child development.

This will be a key focus of the Taskforce’s work as it considers evidence-based interventions across a number of areas. These include improving personalised care and support plans for mothers, addressing how wider societal issues impact maternal health, improving education and awareness of pre-conception health, increasing access to maternity care with targeted support for women from the most vulnerable groups and empowering women to make informed decisions about their care during pregnancy. Critically, it will focus on sharing expertise across the range of maternity services to assess what works so that there can be a long-term improvement.

There’s further positive news with the NHS piloting a new artificial intelligence pregnancy screening tool in London, Yorkshire, Lancashire and Surrey which is hoped will play a part in reducing racial disparities in neonatal mortality. Trials involving more than 20,000 pregnant women found that standard screening led to significant racial disparities but the new tool, used alongside targeted care, reduced baby deaths among mothers from ethnic minority backgrounds by 60%.

Finally, the NHS is aiming to increase the maternity workforce to better support maternity staff and families with a £95 million recruitment drive to hire 1,200 more midwives and 100 obstetricians.

These are all signs of a welcome intent by the Government who want to get to grips with the level and complexity of health inequality and, ultimately, of the lack of opportunity across the country that results. We know that the sharing of best practice, local partnerships and tailored solutions are what works. I hope to see these as key features in the Taskforce’s work. We are still waiting for the broader White Paper on Health Inequality, promised for the spring, but these are positive steps on the road towards effective change that will make a real difference to women and their babies’ lives.

By Rt Hon Anne Milton