Addressing inequity in maternity care outcomes

By Dr Mary Ross-Davie, Director for Professional Midwifery at the RCM and Victoria Komolafe, the RCM’s Professional Digital Advisor on 17 November 2021 Maternity Services Race matters MBRRACE NMPA - National Maternity and Perinatal Audit

Dr Mary Ross-Davie, Director for Professional Midwifery at the RCM and Victoria Komolafe, the RCM’s Professional Digital Advisor, look at two recent reports highlighting the huge inequities in outcomes in maternity care in the UK for women from ethnic minorities and those who live with poverty.

Last week saw the publication of two hard hitting reports from MBRRACE-UK and NMPA which shared more evidence about the inequity of outcomes for women and babies that come through our maternity services in the UK.

There is a lot that the RCM has already been doing, including collaborative projects with King’s College London and MatVat. We have also produced a position statement and podcast on supporting women experiencing severe and multiple disadvantage.

We know that midwives and maternity support workers often struggle to be released for continuing professional development.  The squeeze from the chronic staffing shortage, means that any training often prioritises the mandatory clinical skills updates: obstetric emergencies, fetal monitoring interpretation and neonatal resuscitation.

We have made five commitments to implement our key theme of reducing inequity in maternity care during 2022, by ensuring that our resources for our members address:

  1. The impact of racism and ethnicity on outcomes in maternity care.
  2. The impact of socio-economic deprivation on outcomes in maternity care.
  3. Improving information provision, to support informed decision making on place of birth and types of birth, through ensuring the standardisation and quality of the conversations that are being had around personalised care and support plans. 
  4. Addressing the needs of women with pre-existing conditions that impact on pregnancy including increased BMI, high blood pressure, diabetes and mental health conditions.
  5. Supporting our members to develop the ways in which maternity services engage with the communities they serve and listen to the voices of women and people in their care to shape services.

We want to support members in targeting care appropriately, as well as working with others across education, research, professional guidance, lobbying and influencing to provide high quality care to Black and Asian women, to women from ethnic minorities and to women living with deprivation and in difficult socio economic circumstances, elements which sadly often intersect.

We can’t do this alone. If you would like to support us, through contributing to reviewing and developing  i-learn modules and other educational resources or sharing your work in the area of reducing inequity through presentations at webinars or publishing an article in one of our magazines, we would love to hear from you.  Please email us at [email protected] or [email protected]

Useful Links:

The RCM position statement on caring for women experiencing severe and multiple disadvantage, May 2021  rcm-position-statement-women-experiencing-severe-and-multiple-disadvantage-2021_2.pdf

RCM podcast on caring for women experiencing multiple disadvantage: SMD Podcast - RCM

RCM Professional briefings for care during the COVID-19 pandemic:

Care and support for women experiencing domestic abuse cb-domestic-abuse-during-covid.pdf (

Women from ethnic minorities and the impact of COVID-19  cb-women-from-ethnic-minorities-and-impact-of-covid.pdf (

Public health during COVID-19 pandemic cb-public-health.pdf (

Recent national documents:

Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study - The Lancet

NMPA Sprint Audit on inequalities, November 2021 Ref 308 Inequalities Sprint Audit Report 2021_FINAL.pdf (

The lay summary of the NMPA sprint audit: RCOG_Inequalities Report_Lay_Summary.pdf (

The MBRRACE-UK maternal report, November 2021 MBRRACE-UK_Maternal_Report_2021_-_FINAL_-_WEB_VERSION.pdf (