What are maternal health inequalities, and how are we stopping them?

This is a pivotal moment for maternity services, with growing national focus on improving safety, reducing inequalities, and ensuring women receive high-quality, personalised care throughout pregnancy and beyond. So, what are we doing to help?

Contents:

1. What are maternity health inequalities?
2. The five-year project set to change things
3. Real impact across maternity disparities
4. The future

What are maternity health inequalities?

Good health and wellbeing enable us to live happy, fulfilling lives and free us up to achieve our potential. But we don’t all have the same opportunities to live healthy lives. There are stark health inequalities linked to where we live, the circumstances we grow up in, our ethnicity, and our disability status.

While pregnancy and birth are very safe in the UK, some groups of women are more likely to have a worse experience than others.

Maternity health inequalities refer to the unfair, avoidable, and systematic differences in maternal health outcomes, healthcare experiences, and access to services among different demographic groups.

Discrimination and racism are shown to seriously affect health, through stress and by creating barriers to employment, housing, and health care. For instance, data shows that mothers from Black, Asian, and mixed ethnic backgrounds face significantly higher risks during and after pregnancy.

The data also show the same risks for women living in deprived areas. Deprivation is when people and households lack the ability to attain the essential resources required for a decent quality of life. These include a stable income, warm housing, education and health care.

Deprivation is a major driver of health inequalities, because people in poorer areas might be unable to afford basic necessities, face higher rates of chronic illness, shorter life expectancy, and more years living in poor health. It also limits people’s access to health care and exposes individuals to risk factors like poor housing, food insecurity and stress, creating a cycle of disadvantage.

These inequalities manifest across several well-documented areas, such as mortality rates, birth complications, and disparities across quality of care and experience. For example, research shows that mothers from ethnic minority groups are more likely to report not being listened to by healthcare professionals, facing microaggressions, or not having their pain taken seriously.

But making the long-lasting change needed to address health and social inequalities can’t be done in isolation. No single organisation or profession can do it on their own. It must be a group effort, bringing together experts and patient groups from across the UK to understand how such inequalities vary by region and community, before determining a course of action to change things for the better.

The five-year project set to change things

Newcastle University is co-leading a £50 million national initiative to tackle maternal health inequalities to improve outcomes for women, babies and families across the UK.

Funded by the National Institute for Health and Care Research (NIHR), this five-year project brings together the NIHR Maternity Disparities Consortium – a group of expert clinicians and researchers from nine carefully-selected universities and communities, all dedicated to addressing urgent gaps in maternal care and levelling health inequalities.

While the term ‘inequalities’ refers to the objective, measurable difference in the distribution of opportunities and outcomes between individuals or groups, using the term ‘disparities’ reflects the consortium’s focus on seeing these as the result of unjust systemic barriers and discrimination.

The consortium members span most regions of the UK, ensuring a wide perspective on tackling maternity inequalities. Each member then has its own relationships with its local charities, community groups, maternity services, public health teams and health services, life science industry partners, and patient groups.

With growing national attention on ensuring women receive fair and personalised care through pregnancy and beyond, the formation of this consortium comes at an important time.

This is the moment when ambition must be matched by delivery and impact.

Real impact across maternity disparities

Led by our international experts across maternal and child health, population health, and health inequalities, Newcastle University will play a central role through its leadership in shaping the programme.

The consortium will focus on improving and levelling care throughout the entire reproductive cycle, from pregnancy through to birth and early recovery. It also recognises the vital importance of the time before and between pregnancies, as well as the post-natal period, and will strengthen the support and transitions into longer-term family care.

Researchers will work closely with NHS partners and local communities to ensure that the work reflects real experiences in patient groups. The consortium will assess what works, for whom, and in what contexts, so that the work results in real, practical changes in care for the women, babies and families who need them most.

The consortium’s work will target three different root causes of maternity health inequalities:

• setting up an early evaluation of a preconception and interpregnancy care bundle, to improve health before pregnancy and reduce the build-up of risk
• developing an early evaluation of a maternity care pathway spanning pregnancy, birth and the early postnatal period, focusing on major contributors to maternal morbidity and mortality
• improving neonatal care and follow-up pathways for babies and families at increased risk of adverse outcomes

The future

The consortium will also have a long-term goal of supporting the next generation of researchers in maternal health and care.

‘Alongside the research, the consortium will be investing £10m of the consortium’s budget in tomorrow's research leaders. This will ensure that we have the capacity to deliver on improving pregnancy outcomes, access to, and experience of care for generations to come.’ – Professor Judith Rankin, Consortium Co-lead for Research and Lead for Capacity Development, Newcastle University

While there is no single solution to tackling maternal health inequalities, this national partnership represents an important step forward. By bringing together researchers, healthcare professionals, communities, and families from across the UK and delivering real-world scalable research, the consortium will generate the knowledge needed to better understand why inequalities persist and, crucially, what works to reduce them.

The consortium is working hard for a future where every woman, regardless of her ethnicity, background, income, or postcode, has access to safe, high-quality maternity care and the best possible chance of a healthy and positive pregnancy, birth, and recovery. Through collaboration, innovation and a commitment to listening to the voices of women and families, the project hopes to help create lasting change across maternity services, ensuring fairer outcomes for all.

You might also like…

• read the press release: ‘Newcastle leads £50m Initiative to improve maternity outcomes’
• find out more about the NIHR Maternity Disparities Consortium
• find out more about the work of Professor Judith Rankin, Consortium Co-lead for Research and Capacity Development and Professor of Maternal and Child Health at Newcastle University
• explore the nine carefully-selected universities and communities who’re helping to change maternity care for the better
• find out more about the National Institute for Health and Care Research (NIHR)
• read about the animation illuminating the important of active listening in maternity care: ‘See the Whole of Me: promoting the importance of maternal listening’
• read how expectant mothers who are considered ‘food insecure’ are up to four times more likely to experience stress, anxiety, and depression