Inequalities, safety culture and personalisation

The disparity in outcomes in maternity for black, Asian and minority ethnic (BAME) women giving birth in the UK has been recognised for some time (Nair et al, 2016; Knight et al, 2018; Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK ([MBRRACE-UK], 2017). The coronavirus has forced this disparity in health inequalities to be elevated to national attention like never before (Royal College of Obstetricians and Gynaecologists ([RCOG], 2020).

MBRRACE-UK (2019) provided continual evidence that maternal and perinatal mortality rates were significantly higher for black, Asian, mixed race and minority ethnics. The UK Obstetric Surveillance System's (UKOSS) recent report (Knight et al, 2020) provides further indication of the disproportionate impact in relation to mortality with BAME women. It is suggested that this cannot be simply explained by higher incidence in the main geographical areas with known higher proportions of women from the BAME community, as outcomes were seen when women from areas such as London and West Midlands were excluded. The result also remained in spite of adjustment for age, body mass index and co-morbidities.