Allkins S The ups and downs of midwifery in the UK. Br J Midwifery.. 2023; 31:(6)

Care Quality Commission. The state of health care and adult social care in England 2022/23. 2023. https//

Royal College of Midwives. RCM urges ‘whole system approach’ to end the inequality gap in maternity mortality. 2023a. https//

Royal College of Midwives. CQC report ‘doesn't pull any punches’ say the RCM. 2023b. https//

Reports highlight inequalities in care

02 November 2023
Volume 31 · Issue 11

The last month has seen two key reports for midwifery and maternity services published: the Care Quality Commission's (CQC, 2023) state of care report, and MBRRACE-UK's (2023) final report on saving lives and improving mothers’ care. Both reports highlight key themes relating to care in the UK, including access, quality and concerns from overworked staff.

Inequalities in care were reported in both publications. MBRRACE-UK (2023) emphasised evidence of disparities in outcomes for particular ethnic groups and economic backgrounds, which comes as no surprise after the data used for the report were released earlier this year (Allkins, 2023). According to these data, Black women are almost four times as likely to die during pregnancy than White women, and Asian women are almost twice as likely to die. Similarly, the CQC (2023) noted that both women using maternity services and midwives working in the services were affected by discrimination, racial stereotypes and ‘a lack of cultural awareness among staff ’.

The Royal College of Midwives (2023a) is calling for a ‘whole system approach’ to address these inequalities, with chief executive, Gill Walton, emphasising that this should begin ‘as early as university’. There are currently ongoing efforts to ‘decolonise the curriculum’ in an attempt to promote supportive care for non-White women and families.

The MBRRACE-UK (2023) report also allowed insight into how COVID-19 affected those using maternity services, as the data cover the 2019–2021 period. Overall, 14% of maternal deaths in this time period were attributed to the virus, which was the leading cause of maternal deaths. The report highlights issues around misinformation and vaccine hesitancy, and calls for ‘consistent, clear messaging on vaccination in pregnancy’ moving forward. One of the key recommendations focuses on preparing a route for rapid delivery of advice and data on new vaccines and treatments for pregnant and breastfeeding women.

Both reports emphasise the ongoing struggles in maternity services, and acknowledge the intense burden for services that are understaffed and overworked. External pressures, such as the rising cost of living, add to the stresses faced by those working in maternity services. However, there is hope that by highlighting these concerns, and by acting on the recommendations made by these reports, that this situation can be improved moving forward.