Regulator acts to tackle ‘national emergency’ of racism in maternity care

There is a “national emergency” of racism in maternity care, a regulator has warned as it launched new education tools for universities in a bid to stamp out bias.

Figures show black and Asian mothers are more likely to die in pregnancy, during child birth or in the immediate postnatal period, compared to white women.

Babies born to black and Asian women are more likely to be stillborn.

The Nursing and Midwifery Council (NMC) said racism within maternity services “compounds the problem”, as it launched a new programme.

Equity, diversity and inclusion is already referenced in all midwifery education programmes.

But the regulator, which approves and monitors degree programmes throughout the UK, said it will work with all universities offering midwifery education to make anti-racism, bias awareness and cultural curiosity, safety and respect “more explicit” in their curricula.

These will be put in place by the start of the next academic year, the NMC said.

Paul Rees, NMC chief executive and registrar, said: “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.

“To help tackle the black maternal health crisis we’re calling on our education partners to embed the new principles which will enable us to embed anti-racism, bias awareness and cultural curiosity, safety and respect across all midwifery education in the four countries of the UK.”

The UK Government’s Public health minister Sharon Hodgson added: “The stark disparities in outcomes for black and Asian mothers and babies are unacceptable, and tackling them is a priority for this Government.”

Figures from the MBRRACE programme, which monitors maternal deaths, show that between 2021 and 2023, 257 women died during or up to six weeks after pregnancy among 2,004,184 women giving birth in the UK.

The represents an average death rate of 12.82 women for every 100,000 giving birth.

Among black women this figure was 28.21 per 100,000 women giving birth.

This includes deaths from blood clots and heart disease.

Among Asian women the maternal mortality rate was 16.74 per 100,000 women giving birth.

Maternal mortality rates amongst women from mixed ethnic backgrounds were almost two-fold higher compared to white women, according to the report.

A separate MBRRACE report highlights how babies of black ethnicity were more than twice as likely to be stillborn than white babies in 2023.

The report says that despite a decline in stillbirth rates for all ethnic groups, “significant ethnic disparities persist”.

It says babies of Asian and black ethnicity still have much higher mortality rates than babies of white ethnicity.

‘Disgrace’

Commenting on the new NMC initiative, Gill Walton, chief executive of the Royal College of Midwives, said: “That black, Asian and minority ethnic women continue to face such stark inequalities in maternity care is a disgrace and tackling this must be an urgent priority for the whole profession.

“The NMC’s new anti-racism principles are a vital step in the right direction.”

Professor Nicola Ranger, general secretary and chief executive of the Royal College of Nursing, added: “By embedding anti-racism, unconscious bias awareness and cultural competence training further into the learning of all midwives and nurses, we give our next generation of registrants the best chance of eradicating these unacceptable health inequalities once and for all.”

Professor Habib Naqvi, chief executive of the NHS Race and Health Observatory, said: “Racism in midwifery and nursing is a significant public health issue that undermines staff wellbeing and patient safety.

“That’s why it’s important that we address the structural barriers that place black, Asian and minority ethnic women at increased risk is essential.

“This requires a clear commitment to challenge bias and discrimination wherever you find it, including within education.

“We therefore welcome the new principles designed to embed anti racism and cultural competence across midwifery and nursing education in the UK.”