Maternity staff shortages have become “a barrier” to tackling racial inequalities and disparities within maternity care, a report by MPs has found.
The Women and Equalities Committee report on Black maternal health, published today, called on the government to pledge more money towards a fully staffed and properly funded maternity services workforce.
“One of our biggest concerns is staffing shortages in maternity care”
Black women are almost four times more likely to die from childbirth than White women.
Meanwhile, women in the most deprived areas are 2.5 times more likely to die than those in the least deprived areas.
In the report, MPs explained that causes of disparity in maternal deaths were “multiple, complex and still not fully understood”.
The committee warned that too many Black women had experienced treatment “that falls short of acceptable standards”.
“We are concerned that the Government and NHS leadership have underestimated the extent to which racism plays a role,” said the report.
Meanwhile, the report highlighted that “considerable maternity staff shortages” had become a barrier to tackling inequalities and implementing safety measures, such as the continuity of care model.
It said: “A fully staffed, properly funded maternity services workforce is fundamental to delivering safe, personalised care to pregnant women and new mothers, and a prerequisite to rolling out any measures to combat inequalities.”
The Department of Health and Social Care (DHSC) has expanded midwifery training places by 3,650 a year, as well as introducing training grants of at least £5,000 a year.
However, the report called on the government to act on recommendations made by the previous Health and Social Care Committee chair, Jeremy Hunt, now the chancellor, to increase the annual budget for maternity services to £200-350m.
This funding recommendation was endorsed by the Ockenden report into maternity service failings at the Shrewsbury and Telford Hospital NHS Trust.
The committee also urged for the maternity workforce to be “properly equipped to understand and recognise the significant disparities that exist”, and to use that knowledge in practice.
It called for a review to ensure that all maternity staff and students were receiving evidence-based learning on maternal health disparities, their causes and how to deliver “culturally competent” care.
MPs warned that at the time of writing the report, the Maternity Disparities Taskforce had not met for nine months.
The taskforce, launched in February 2022, was set up to tackle disparities for mothers and babies and reduce maternal and neonatal deaths, by improving maternity care for women from ethnic minorities.
It is made up of representatives from several key health and social care bodies, including the Royal College of Nursing and the Royal College of Midwives (RCM).
The report called on the government to publish metrics which could measure the success of the taskforce, and urged it to report back to the Women and Equalities Committee on the progress that it has been making.
“We are absolutely clear that we must ensure maternity care is of the same high standard, regardless of race”
Department of Health and Social Care spokesperson
Overall, the committee found in its report that measures which had been put in place by the government to address the disparity in maternal deaths were “necessary but insufficient”.
The report concluded that a target for eliminating the disparity between Black and other minority ethnic women and White women was needed, and that the Maternity Disparities Taskforce should be responsible for “developing the metric by which this target can be achieved and measured”.
Chair of the Women and Equalities Committee, Caroline Nokes, said: “One of our biggest concerns is staffing shortages in maternity care.
“We need to see a sustained uplift in funding to bolster a workforce that has been stretched to its limits.
“We are also afraid the Government and NHS have not fully grasped that racism has played a key part in the complex reasons underlying the disparities, and that eradicating it is part of the solution.”
She added: “It is frankly shameful that we have known about these disparities for at least 20 years – it cannot take another 20 to resolve.”
Responding to the report, the chief executive of the RCM, Gill Walton, said: “Black and Asian women are too often not being listened to by staff on the frontline, nor are their voices being heard by those running and designing maternity services: this must change.
“We must eradicate the gap once and for all and make maternity care safe for everyone.”
Ms Walton added that maternity services and staff were “over-stretched and over-burdened”.
She said: “Too often we see midwives pulled from crucial antenatal and postnatal care, where midwives have important discussions with women, to make labour and birth safe.
“This should not have to happen, and all parts of the service should be resourced effectively.”
Meanwhile, the chief executive of NHS Providers, Julian Hartley, said: “Disparities in maternal deaths are unacceptable, especially when NHS births are among the safest in the world. The NHS can, and must, do better.
“Trust leaders are committed to addressing inequalities in maternal care and providing high-quality personalised care to all mothers.
“As this report shows, much more progress is needed to improve care and outcomes for Black mothers as well as efforts to tackle staff shortages in maternity services.”
Also responding to the findings, a DHSC spokesperson said: “While the NHS is already one of the safest places to give birth in the world, we are absolutely clear that we must ensure maternity care is of the same high standard, regardless of race.”
The spokesperson noted that DHSC had invested £165m since 2021 to grow the maternity workforce, and also cited the additional 3,650 training places that had been made available.
They added that the Maternity Disparities Taskforce was meeting today and that its focus was on “how we can eradicate disparities and improve maternity outcomes for all mothers”.