Health and Social Care Committee calls for urgent
action to address culture, workforce shortages, data collection
and leadership
Black women in England face disproportionately poor outcomes in
maternity care, shaped by systemic failings in leadership,
training, data collection and accountability, according to a new
report from the Health and Social Care Committee, Black
Maternal Health.
The inquiry heard repeatedly that racism is ‘one of the core
drivers' of poor maternal outcomes for Black women, as MPs heard
from clinical experts and women about cases where racist
assumptions had directly harmed Black women's care. Black
women are 2.3 times more likely to die in pregnancy, childbirth,
or the postnatal period than White women, according to recent
figures.
The report acknowledges that failings in care for Black women are
taking place in the context of a maternity system that is failing
women more broadly, with the NHS in England having paid £27.4
billion in maternity negligence since 2019, estimated at, a
figure greater than the total maternity budget for the same
period.
Given those outcomes, the Committee says it is ‘indefensible'
that cultural competency training is optional for NHS
staff and leaders working in maternity services, including
midwives. The report urges the Department for Health and Social
Care to work with the NHS, the Royal College of Midwives and the
Nursing and Midwifery Council to introduce mandatory cultural
competency training for all midwives, which they say should be
informed directly by the experience of Black women.
The acting Chair of the Health and Social Care Committee,
MP, said:
“Safe maternal care for Black women depends on a workforce that
listens to, understands and respects their needs. For that to
happen, maternal services must be properly prepared, equipped and
resourced. Leadership must be effective but it must also be
accountable. This report proves that this is not, currently, the
case.
“In June, the Government launched a rapid national investigation
into NHS midwifery and neonatal care. In-built structural racism
in maternity services repeatedly fails black women. Acknowledging
this and addressing racial disparities in maternal outcomes must
be one of the investigation's core aims. This has to be the
turning point for England's maternity services and particularly
for Black women if we are to achieve equity.”
Along with recommendations to address culture, leadership and
racism, the report identifies workforce concerns, a shortage of
data and cuts to funding as four key strands of the Committee's
report.
Workforce: While staffing has recently improved,
the Royal College of Midwives (RCM) reported that the NHS in
England faces a shortfall of over 2,500 midwives, with many
services operating below safe staffing levels. The report presses
the Department to deliver tools to monitor and deliver safe
staffing levels for maternity services.
Data: MPs heard that gaps in data “may obscure
the true extent of disparities in outcomes for Black and other
minority ethnic women.” They repeatedly heard that
disparities in maternal outcomes could not be improved without
better data relating to maternal morbidity. The
Committee urges the Government to accelerate development of a
maternal morbidity indicator, which it had originally committed
to producing over two years ago.
Funding: Previously targeted funding
through the central Maternity Service Development Fund has been
cut from £95 million to £2 million, with funding now to be
accessed by Integrated Care Boards. MPs are concerned this puts
maternity services in direct competition with other local
priorities and have called for this dedicated funding to be
restored.
Ends
Notes to editors:
- MBRRACE-UK conducts detailed reviews of maternal deaths to
identify systemic failures and opportunities for improvement. The
Committee drew from the annual surveillance
report, published in January 2025, relating to the period
2021-23.
