We have made significant improvements in maternity care: an 18.8% reduction in stillbirths (Office for National Statistics (ONS), 2018a), a 5.8% reduction in neonatal mortality (ONS, 2018b) and an 8% reduction in maternal mortality (Knight et al, 2018). Unfortunately, when compared to white babies, black babies had a 121% increased risk for stillbirth and a 50% increased risk for neonatal death; while in 2016, Asian babies had a 66% increased risk of neonatal mortality (compared to 38% in 2014). Black and Asian women also had a higher risk of dying in pregnancy (40/100 000 and 15/100 000, respectively), compared to white women (8/100 000) (Draper et al, 2018; Knight et al, 2018). Neonatal death rates were also higher for babies of mothers in the most deprived areas (Draper et al, 2018; Knight et al, 2018).
The NHS Long Term Plan (NHS, 2019), promises help for maternity providers to improve care for women and babies. Chapter 3 of the Plan has a strong maternity focus (Box 1), but reading the whole document shows how health could be improved across patients' lives.
The Plan shows that to reduce health inequalities, actions must be universal, but with a scale and concentration that is proportionate to the depth of disadvantage (known as proportionate universalism). Consequently, the plan aims to enhance continuity of carer for the most vulnerable mothers and babies and provide services for women from the most deprived communities who, when compared with women from affluent areas, are 12 times more likely to smoke during pregnancy (NHS, 2019).
Other plans aim to increase information and access through the digital health records, improve perinatal mental healthcare, and provide pelvic health clinics to promote long-term pelvic floor health for the approximately 1 in 3 women who experience incontinence after childbirth (Thom and Rortveit, 2010). The Plan even includes improvements to neonatal services.
The workforce required to deliver the Plan is partly addressed with more to be announced once the budget for higher education is set later this year.
The next 10 years will see ambitious improvements in healthcare provision in England and I believe that this Plan will support the NHS and in particular maternity services to be the safest in the world, so that when we celebrate the 80th birthday of the NHS, we look back with a sense of achievement.