Recent reports suggest that the Government’s response to curbing the spread of Covid-19 did not do enough to support the challenges or needs of migrants living in the UK.
Equity means that all mothers and babies will achieve health outcomes that are as good as the groups with the best health outcomes. For this, maternity and neonatal services need to respond to each person’s unique health and social situation – with increasing support as health inequalities increase – so that care is safe and personal for all. This will help us ensure that England is the safest place to be pregnant, give birth and start parenthood.
Maternity and neonatal services contribute to the health, wellbeing and socioeconomic development of the nation. Good health in pregnancy significantly influences a baby’s development in the womb which, in turn, influences long-term health and educational outcomes.1 By giving every child the best start in life, we will help them fulfil their health, wellbeing and socioeconomic potential.
The MBRRACE-UK reports about maternal and perinatal mortality show worse outcomes for those from Black, Asian and Mixed ethnic groups and those living in the most deprived areas. And there is strong evidence highlighted in the NHS People Plan that:
“…where an NHS workforce is representative of the community that it serves, patient care and…patient experience is more personalised and improves”.
If equity for mothers and babies is to improve, so must race equality for staff.
1 Marmot M, Goldblatt P, Allen J, et al (2010) Fair Society Healthy Lives (The Marmot Review)
The NHS has therefore set out two aims for maternity and neonatal care:
NHS staff, Maternity Voices Partnerships, the voluntary, community and social enterprise (VCSE) sector and others are doing incredible work to improve equity and equality. Yet, if we are to achieve equity, even more needs to be done to address the social determinants of health. The NHS Long Term Plan (p33) calls for a greater focus on the social determinants of health by the public, private and third sector.
Our four pledges have been developed by examining the evidence and consulting Maternity Voices Partnerships, staff, royal colleges, arm’s length bodies, government, the VCSE sector and others. Thank you to all those who have contributed – you have made this work all the stronger.
Everyone can help to achieve our equity and equality aims. Let’s commit to work together to improve equity for mothers and babies and race equality for NHS staff.
Our 4 equity and equality pledges for maternity and neonatal care
To achieve our equity and equality aims, we make four pledges to women, babies, families and staff:
The NHS will take action through a five-pronged approach:
1. understand your population and co-produce action plans
2. take action on maternal mortality, morbidity and experience
3. take action on perinatal mortality and morbidity
4. support maternity and neonatal staff
5. create the conditions to achieve equity (enablers)
Each element is supported by underlying interventions, designed to address the needs of specific ethnic and socio-economic groups.
Local maternity systems (LMSs) will work in partnership with women and their families to draw up and publish Equity and Equality Action Plans. There is a two-step process for LMSs to produce their plans: by 30 November 2021, submit an equity and equality analysis (covering health outcomes, community assets and staff experience) and set out how they will work in partnership with women and their families to draw up the plans; and by 28 February 2022, submit Equity and Equality Action Plans.
LMSs will receive £6.8m to co-produce and implement their Equity and Equality Action Plans and implement targeted and enhanced continuity of carer. LMSs will receive support and guidance from regional maternity teams, clinical networks and integrated care systems (ICSs).
The NHS will track the outcome of its plans. The NHS will continue to track:
The next step is to devise a measure about serious complications (known as ‘near misses’) experienced by women as a result of pregnancy and birth; the Department of Health and Social Care has tasked experts to work out how to do this. Information to help families keep well in pregnancy and beyond as well as the four pledges, the NHS has set out top tips to help women and families keep well in pregnancy and beyond.
Use trusted sources of advice
The NHS healthy weight site helps you work out what a healthy weight is for you and how to get there. Take vitamin D and folic acid as recommended. Check if you have iron deficiency anaemia, which is common in pregnancy.
Healthy Start vouchers help you give your children a great start in life – they are for vitamins and basic foods. Ask your midwife if you qualify.
Keep active and fit during pregnancy: find out why and get exercise tips here.
Know when to call your midwife or maternity services
Maternity services are open 24 hours a day, 7 days a week. If you do not have a midwife or maternity team call a GP or use the NHS 111 online service (if you cannot get help online, call 111).