Story Highlight
– Regulator declares maternity care racism a “national emergency.”
– Black and Asian mothers face higher mortality rates.
– NMC launches program to combat bias in education.
– Urgent need for anti-racism in midwifery curricula.
– Disparities in outcomes for Black and Asian mothers unacceptable.
Full Story
A recent announcement from the Nursing and Midwifery Council (NMC) has drawn attention to what it describes as a “national emergency” regarding racism in maternity care. Alongside this declaration, new educational resources are being developed for universities to tackle biases and ensure equitable care. Current statistics reveal that Black and Asian mothers face disproportionately higher risks of mortality during pregnancy, childbirth, and shortly after delivery compared to their white counterparts. Furthermore, infants born to Black and Asian mothers also show higher rates of stillbirth.
The NMC, which is responsible for the regulation of nursing and midwifery education across the United Kingdom, has emphasized the need for reform in educational curricula to better address issues of racism and bias within the maternity services. It has announced initiatives aimed at incorporating principles of equity, diversity, and inclusion into midwifery education more explicitly. Starting from the beginning of the next academic year, the NMC will collaborate with universities to enhance the focus on anti-racism, bias awareness, and respect for cultural differences in their teaching.
Paul Rees, the chief executive and registrar of the NMC, has underscored the urgency of the situation, stating, “The evidence is clear that racism within maternity services compounds the problem. Black and Asian women are more likely to die during pregnancy or in the immediate postnatal period, and their babies are more likely to be stillborn. The situation is totally unacceptable and is a national emergency.” He has called upon educational institutions to adopt new principles that will enrich anti-racism and cultural respect throughout the UK’s midwifery training.
Public health minister Sharon Hodgson has reiterated the government’s commitment to addressing these disparities, remarking that “the stark disparities in outcomes for black and Asian mothers and babies are unacceptable, and tackling them is a priority for this Government.”
According to data from the MBRRACE programme, which tracks maternal deaths, between 2021 and 2023, there were 257 maternal deaths among the over two million women who gave birth in the UK. This translates to an average maternal death rate of 12.82 for every 100,000 women in childbirth. For Black women, this rate surged to 28.21 per 100,000, while for Asian women, it stood at 16.74 per 100,000. Moreover, the report indicated that maternal mortality rates among women from mixed ethnic backgrounds were nearly double those of white women.
A related MBRRACE report from 2023 has highlighted alarming figures regarding stillbirth rates, indicating that babies of Black heritage are over twice as likely to be stillborn compared to those of white ethnicity. Although there has been some progress in reducing stillbirth rates across various ethnic groups, significant disparities remain. The report confirms that babies born to Asian and Black mothers continue to face significantly higher mortality rates than those born to white mothers.
Gill Walton, chief executive of the Royal College of Midwives, commented on the NMC’s new initiative, stressing that the ongoing inequalities in maternity care for Black, Asian, and minority ethnic women are a source of shame for the profession and demand urgent attention. “The NMC’s new anti-racism principles are a vital step in the right direction,” she asserted.
In support of the initiative, Professor Nicola Ranger, general secretary and chief executive of the Royal College of Nursing, noted the importance of integrating anti-racism and cultural competence training into the educational framework for future midwives and nurses. “By embedding these principles into the learning of all midwives and nurses, we can equip the next generation of practitioners to eliminate these unacceptable health inequalities,” she said.
Professor Habib Naqvi, head of the NHS Race and Health Observatory, emphasized that racism in nursing and midwifery represents a critical public health issue that can jeopardize both staff wellbeing and patient safety. He stated, “Addressing the structural barriers that place Black, Asian, and minority ethnic women at increased risk is essential. This requires a firm commitment to challenge bias and discrimination in all forms, particularly within educational programs.”
As the UK grapples with these concerning findings, the introduction of new educational reforms by the NMC marks a significant step towards addressing the systemic issues faced by minority ethnic women during maternity care. The commitment to incorporating anti-racism training is expected to pave the way for improved outcomes and greater equity in service delivery. The collaboration between the NMC, educational institutions, and health professionals will be crucial in shifting the landscape of maternity care and ensuring that all mothers receive the safe and respectful treatment they deserve. As calls for action increase, the primary focus remains on protecting the health and rights of women and their infants, irrespective of their ethnic background.
Our Thoughts
To prevent the disparities and fatalities identified in the report, several key actions could have been implemented to enhance safety and care quality in maternity services. First, it is essential to establish robust training programs that specifically address unconscious bias, cultural competence, and anti-racism within the curriculum of midwifery and nursing education, as proposed by the NMC initiative. Consistent application of these training principles would align with the Health and Safety at Work Act 1974, which mandates the protection of health and safety of all employees and service users.
Furthermore, the Equality Act 2010 should have been rigorously enforced to ensure that health outcomes are equitable across all ethnic groups, emphasizing the need for systematic monitoring of maternity services to identify and act upon discriminatory practices promptly. Implementing comprehensive risk assessments for maternal health that consider ethnic disparities could help healthcare providers understand and mitigate the risks faced by Black and Asian women.
Lastly, fostering an environment of open communication where patients feel safe to voice concerns could prevent incidents of inadequate care. By focusing on these safety lessons, the healthcare sector can strive to create a more equitable and effective maternity care system, ultimately reducing mortality rates among minority ethnic women.
