Latest report confirms long way to go to address shocking maternal deaths disparity for BAME women

19th January 2021 Clinical Negligence

The seventh annual report from MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries) reviewed maternal deaths in the UK between 2016 and 2018.

The report found that 29 per cent of women who died had received good care. However, improvements in care, which could have made a difference to the outcome, were identified in 51 per cent of women who died. That statistic alone shows how much more needs to be done to improve maternal care in pregnancy.

When it came to racial disparity the report found that Black women are four times more likely than white women to die in pregnancy or childbirth and women from Asian ethnic backgrounds face twice the risk that white women do.

As well as ethnicity the report also found that socio-economic status affected outcomes, with women living in the most deprived areas being three times more likely to die than those in more affluent areas.

The report highlighted there was a constellation of biases in play when it came to maternal death in the UK.  Almost all of those who died during or after pregnancy (90 per cent) had multiple issues ranging from mental or physical health to living in a deprived area with limited access to joint up care, which affected the care that they received.

This continued disparity in maternal mortality simply because of women’s ethnicity is shocking and unacceptable.

The report does not explain why there is such a disparity in care for Black and Asian mothers and what is causing their deaths. Some of the possible reasons highlighted in the report include racial bias, lack of culturally appropriate care including in some cases complicating factors around immigration status.

The lack of support services in the community in this country tends to be amplified in Black and Asian communities who often live in areas of social deprivation. I feel that the lack of services and difficulty accessing services impacts on both parents-to-be and their babies. Prior to delivery they struggle to access antenatal services, often not knowing when and where to turn for support.

Whilst the report only focuses on maternal deaths more action is also needed to look at why Black and Asian mothers and their babies are having poorer outcomes. It is recognised that Black babies have a 121 per cent increased risk of stillbirth and a 50 per cent increased risk of neonatal death compared to white babies. Asian babies have 55 per cent increased risk of stillbirth and 66 per cent risk of neonatal death.

This is the third MBRACCE report to highlight these discrepancies, yet still the same problems are occurring. I hope that with more and more reports highlighting these systemic issues more work will be done urgently to address the inequalities, which have also been seen with tragic effect during the ongoing Covid 19 pandemic. The pandemic has amplified the impact of the social and ethnic inequalities on healthcare and outcomes in the UK.

I would like to see the government commit to the work by the Royal College of Obstetricians and Gynecologists and campaigners Five X More to achieve their target of a 50 per cent reduction in maternal mortality for Black, Asian and minority ethnic women over the next five years. However, to do that the work needs to start now, without waiting for another report




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Suleikha Ali is an Associate located in Londonin our Clinical Negligence department

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