Empowering Migrant Women: Midwives and NHS Policy Reform

By Rachel Drain on 17 May 2024

Migrant and asylum seeking women affected by NHS charging are disproportionately likely to be from Black or marginalised ethnic groups.  Additionally, we know the health outcomes for these women and their babies are significantly worse, particularly for Black African and Caribbean women, than those for white British women.  This has been demonstrated repeatedly through MBRRACE reports and although slight improvements have been shown there remains much progress to be made.   

Midwives are part of the solution!  We are positioned to enable change and drive improvements through our role in supporting women and people accessing maternity care.  However, evidence shows us that charging for NHS maternity care is deterring women from seeking care from a midwife.  The women who stand to benefit most from a caring, supportive relationship with a trusted midwife are those who are most likely to withdraw from antenatal, perinatal and postnatal care due to concerns of incurring insurmountable debts they will be unable to repay or suffering Home Office sanctions for those unpaid debts.   

We at The Royal College of Midwives have partnered with The Royal College of Obstetricians and Gynaecologists and Maternity Action to release an updated Access Guide which has been produced to assist NHS Trusts in improving access to maternity care for women affected by NHS charging.  Recognising that often pregnant migrant women are uniquely vulnerable, we as midwives remain committed to tackling the health inequalities this group of women face.  This Access Guide aims to add clarity to the current regulations and guidance and offers ways in which policy and practise at Trust level can be improved.   

Charging regulations are negatively impacting on the health and wellbeing of vulnerable migrant women and their babies and they should be revoked with immediate effect.  Until then, this Access Guide offers practical best practice recommendations for NHS Trusts, will support providers to make changes to their policies and practices and most significantly will help to increase the knowledge of midwives so they can support women to navigate the barriers to accessing care posed by NHS charges. 

As midwives, we may know the privilege it is to support a women who has endured a difficult journey to a place of safety, sometimes with horrific experiences forming part of her story.  Wrapping care around these families can be some of the most rewarding work we can do.  This publication can help to ease some of the continued fears and burdens these women may have.  We urge midwives to engage with this resource; share with finance departments, overseas visiting teams, senior management and policy makers in order to make real impacts in improving women’s experience of accessing maternity care and the outcomes they experience.

View the Maternity Action seminar: What can NHS Trusts do to promote access to maternity care?