CQC reports racial inequality in maternity care

Maternity and Newborn Safety Investigations (MNSI), which is part of the Care Quality Commission (CQC), is a safety programme that examines maternal or neonatal death, stillbirths and babies born with severe brain injuries across the NHS in England. NHS trusts are required to report certain patient safety incidents to MNSI to allow for independent investigations to be carried out. 

The Guardian’s investigation found that more than 2,300 investigations were completed by MNSI between 2020 and 2023 into cases including the tragic deaths of babies before, during and soon after birth, and the deaths of expectant or new mothers. For every 1,000 deliveries by black women, there were 2.3 investigations, compared with 1.3 for white women.

Leigh Day worked on the Birthrights inquiry into racial injustice and human rights in UK maternity care, which was published in 2022. Analysis of the evidence before the inquiry revealed the following common themes in the maternity care experienced by black, brown and mixed ethnicity women:

• Lack of physical and psychological safety
• Being ignored and disbelieved
• Racism by caregivers
• Dehumanisation
• Lack of choice, consent and coercion
• Structural barriers
• Workforce representation and culture 

 The inquiry report made multiple calls for action to try and drive improvement and equality:

• Commit to be an anti-racist organisation
• Decolonise maternity curriculums and guidance
• Make Black and Brown women and birthing people decision-makers in their care and the wider maternity system
• Create safe, inclusive workforce cultures
• Dismantle structural barriers to racial equity through national policy change

The report also suggested concrete steps as to how such actions could be achieved. It is disappointing that the findings published in the Guardian today indicate that no progress appears to have been made to improve outcomes for black mothers since the conclusions of the 2022 Birthrights Inquiry. Racial inequality in healthcare, highlighted in the Birthrights Inquiry, the Guardian investigation and countless other research papers, must be recognised as a persistent and systemic issue, which needs to be taken seriously and addressed urgently.

Leigh Day would like to see action taken via a collaborative approach between healthcare systems, the government and other relevant bodies to ensure that positive change and improvement is brought about on a national level.