Urgent action is needed to address racism, workforce shortages, poor data collection, and weak leadership in maternity services, a new parliamentary report has warned.

The Health and Social Care Committee report “ Black Maternal Health” found that systemic failings were leaving Black women in England facing disproportionately poor maternity care outcomes.

Maternity services were in a “state of crisis,” the committee said, and progress had been “slow and uneven” despite repeated efforts at reform.

Disparities in Outcomes

Black women were 2.3 times more likely than White women to die during pregnancy, childbirth, or the postnatal period. Racism was identified as “one of the core drivers” of these disparities, with assumptions based on race directly harming care. 

Although this was lower than the “almost five times” risk reported by MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries) between 2014 and 2016, MPs warned that the reduction was partly attributable to worsening outcomes in other ethnic groups, not meaningful progress for Black women.

“In-built structural racism in maternity services repeatedly fails Black women,” said Paulette Hamilton, MP, the committee’s acting chair.

She added that tackling racial disparities must be a core aim of investigations into maternity care and called for this to be a “turning point” for England’s services if equity is to be achieved.

Wider Failings in Maternity Services

The committee said poor care for Black women was occurring within a system already “failing women more broadly.”

Since 2019, the NHS in England has paid £27.4 billion in maternity negligence costs, a figure estimated to be more than the total maternity budget for the same period. 

MPs said it was “indefensible” that cultural competency training remained optional for NHS staff and leaders. They recommended making such training mandatory for all midwives, informed by the experiences of Black women.

Workforce Pressures

The report highlighted long-standing workforce shortages, with the Royal College of Midwives (RCM) reporting a shortfall of more than 2500 midwives in England.

The committee urged the government to provide tools to monitor and deliver safe staffing levels in maternity services.

MPs warned that inadequate data collection was obscuring the full scale of disparities. They called for faster development of a maternal morbidity indicator to track outcomes.

The report also criticised cuts to central funding. The Maternity Service Development Fund was reduced from £95 million to £2 million, leaving services to compete with other local priorities for resources through Integrated Care Boards. The Committee called for this dedicated funding to be restored. 

“Safe maternal care for Black women depends on a workforce that listens to, understands, and respects their needs,” said Hamilton. “For that to happen, maternal services must be properly prepared, equipped and resourced.”

She added: “Leadership must be effective, but it must also be accountable. This report proves that this is not, currently, the case.”

Rob Hicks is a retired National Health Service doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online publications. He is based in the United Kingdom.