Black women are five times more likely to die as a result of complications in pregnancy than white women, a report has found.
The Mbrace report, by a team at the National Perinatal Epidemiology Unit at the University of Oxford, looked into maternal deaths in the NHS from 2015 to 2017.
It found that 209 women died during or up to six weeks after pregnancy during that period, with heart disease the single biggest cause. Maternal suicide is the leading cause of death in the first year after pregnancy.
The rate of pregnancy-associated deaths is five times higher for black women and double for Asian women compared to their white counterparts.
For women of mixed ethnicity the risk is threefold.
The Mbrace report, by a team at the National Perinatal Epidemiology Unit at the University of Oxford, looks into maternal deaths in NHS from 2015 to 2017 (Photo: PA)
Researchers described the inequalities between ethnicity as “significant” and acknowledged that more research is needed to understand what is driving them.
“Understanding these disparities needs urgent research and action,” they said.
The report also revealed that three women died due to delays in seeking care over fears they would be charged a fee because of their immigration status.
Charging overseas visitors for NHS care became a legal requirement in 2015. Upfront charging came into force in 2017 and can include charging failed asylum seekers. Charges for standard maternity care start at £7,000.
Under the Government’s regulations those in need of “immediately necessary and/or urgent” NHS care should receive it without having to pay in advance, regardless of their immigration status. But the rule can be misapplied, leading directly to those who cannot afford to pay the charges to miss out on treatment.
Commenting on the deaths, the report said: “There was a suggestion that this woman and two others whose deaths are considered in this chapter may have been reluctant to access care because of concerns over the costs of care and the impact of their immigration status.
“Although no woman will be refused emergency treatment, this may not be commonly known. The importance of maternity care is recognised and is the only service explicitly classed as being ‘immediately necessary’ in the regulations, meaning it cannot be withheld even if a woman has no means to pay.
“However, women may believe they will be asked to pay in advance for planned treatment and this may act as a disincentive to seeking care.”
In its Duty of Care? report published in September, Maternity Action found three main consequences of the policy. Midwives face conflicts in their professional practice as a result of charging and also experience an increased workload as a result of women’s responses to charging.
Many find themselves having to deal with ethical dilemmas about how far they need to engage with the charging regime.
The charity previously called on the Government to immediately suspend charging for NHS maternity care given the deterrent effect on women’s access to maternity care.
Among several recommendations the report calls for immigration rules to be amended to stop debt from maternity care affecting future immigration applications as the fear of being reported to the Home Office affects women’s engagement with maternity services.
A spokesperson for the Department of Health and Social Care said: “The NHS will never refuse maternity care and we recently invested £1 million to expand a team of NHS experts to help hospitals understand cost-recovery rules and exemptions consistently, making clear that urgent treatment – including all maternity services – should never be withheld.”
Written by: Zlata Rodionova