Black Maternal Health Awareness Week

Jess Brown-Fuller Excerpts

Tuesday 29th April 2025 Westminster Hall

[Jess Brown-Fuller (Chichester) (LD)]

I congratulate the hon. Member for Clapham and Brixton Hill (Bell Ribeiro-Addy) on securing today’s important and timely debate, following Black Maternal Health Awareness Week earlier this month. Her opening remarks were comprehensive and thoughtful. I am always pleased to hear from the hon. Member for Sherwood Forest (Michelle Welsh), who is a passionate advocate for improved maternity services in Nottingham and across the UK; I am pleased to serve on the APPG with her at the helm.

Women are at their most vulnerable during pregnancy, as they carry another human life, and they deserve the very best care. They have more touchpoints with the NHS than they will have for most of their lives. We engage with the NHS when we are born and when we need to access care at the end of our lives. When we are carrying a child, we have more moments in front of medical professionals than for the majority of our lives.

Following its inspection of 131 maternity units, the Care Quality Commission found that 65% were not safe for women to give birth, 47% required improvement on safety, and 18% were inadequate. The commission warned that it is concerned about the potential normalising of serious harm in maternity care. Those risks are particularly stark for women of colour in this country, for whom pregnancy continues to carry an unacceptable level of danger. As the Darzi report highlighted, black women are almost three times as likely as white women to die during childbirth, while neonatal mortality among the most deprived quintile is more than double that among the least deprived. That is nothing less than a national scandal.

Maternity care is an issue close to my heart, having had two very different experiences giving birth in my local hospital in Chichester. I tabled an early-day motion on maternity care and secured a Backbench Business debate in this Chamber on that subject just two months ago. Like the hon. Member for Sherwood Forest, I am in regular contact with Donna Ockenden, who produced the Ockenden report. Her findings, along with those of Dr Bill Kirkup, show that the problems identified at the Shrewsbury and Telford trust and the East Kent trust are not isolated incidents. The same issues are systemic and widespread across many NHS trusts up and down the country.

In preparation for the previous debate on maternity services as a whole, I spoke to families across the country who had experienced devastating failures in the system. They went into hospital expecting the joyful outcome of going home with a child, but instead they had to return without their baby, carrying the trauma of that experience for the rest of their lives.

As the hon. Member for Clapham and Brixton Hill mentioned, the MBRRACE-UK report for 2021 to 2023 confirms that inequalities in maternal mortality rates persist, with a nearly threefold difference among women from black ethnic backgrounds, and an almost twofold difference among women from Asian ethnic backgrounds, compared with white women. Women living in the most deprived areas continue to experience maternal mortality rates that are twice those in the least deprived areas. Care for black women who experience stillbirth or neonatal death is often inadequate.

Ethnicity is still not routinely recognised as a risk factor in, for example, the screening and prevention of conditions such as gestational diabetes. Births to black mothers are almost twice as likely to be investigated for NHS safety failings, and black mothers are twice as likely to suffer from perinatal mental illness compared with their white counterparts.

I pay tribute to my hon. Friend the Member for Twickenham (Munira Wilson), who has long talked about these disparities. She introduced the Miscarriage and Stillbirth (Black and Asian Women) Bill in 2022, which sought to require the Secretary of State to lay annual reports before Parliament on efforts to reduce miscarriage and stillbirth rates among black and Asian women, but unfortunately it was not carried over into the next Session.

When so many of our conversations in this House and in the other place are about the economic pressure we are under as a country, it is worth reflecting that, on top of the enormous human toll of this issue, failure also has a financial cost. Obstetric claims make up just 13% of clinical negligence cases handled by NHS Resolution, but they cost more than £1 billion a year, which is nearly 60% of the total cost.

Across the country, families face unbearable grief and trauma because of failures in maternity care, and that burden is falling disproportionately on black women and families. We Liberal Democrats are committed to transforming maternity services to make the UK the safest place in the world to have a baby, and we fully support the work of Black Maternal Health Awareness Week in drawing attention to these critical issues. Our general election manifesto pledged to revolutionise perinatal mental health support, not only for those currently pregnant and for new mothers but for those who have endured miscarriage or stillbirth.

We have been clear that the Government must, as a priority of the highest urgency, implement all the immediate and essential actions recommended by the Ockenden report. It is deeply concerning that, years after the tragedies at the Shrewsbury and Telford trust and the East Kent trust, failures are still widespread and efforts to address them appear piecemeal.

When my hon. Friend the Member for North Shropshire (Helen Morgan) recently questioned the Department on the implementation of the Ockenden recommendations, it was alarming that it could not confirm whether the actions had been implemented, nor did it appear to have a system for centrally monitoring the progress. The Minister pointed to the three-year delivery plan for maternity and neonatal services as the Department’s main response.

Deeper analysis shows serious shortcomings. Many measures in the plan have no meaningful numerical targets, which makes real accountability for the difference made by the plan very hard to track. Targets for expanding access to perinatal mental health support are being missed, even as some improvement is noted, and staff satisfaction indicators remain worryingly low, with some measures still recording fewer than half of staff expressing confidence in educational opportunities or in their management’s response to unsafe practices.

The target set in 2010 to halve maternal mortality looks increasingly out of reach. Maternal mortality rates did not fall for a decade, and they actually increased between 2021 and 2023. Worse still, no updated data has been published for the last two years on the rates of serious brain injury, stillbirth, neonatal mortality or preterm birth. Without transparency and accountability, women will continue to be failed, and black women, who already bear the brunt of the disparities, will continue to be disproportionately harmed. That is why I ask the Minister to commit to reviewing these issues urgently, to meet me and my colleagues from the Liberal Democrat health team to discuss a more effective plan to improve maternity safety, and to set out a clear path to address the deep disparities in black maternal health.

Alongside that, the Liberal Democrats are calling for a cross-Government strategy, led by the Department of Health and Social Care, with annual progress reports on reducing miscarriage and stillbirth rates among ethnic minorities. We also call for increased funding for public health initiatives, with a portion earmarked to allow communities facing the worst health inequalities to co-produce solutions tailored to their specific needs. We propose the establishment of a health creation unit in the Cabinet Office to lead work across Government to improve health and tackle inequalities.

Black women have waited too long for their concerns to be heard, for the system to change and for justice to be done. We owe it to them and to every woman, family and baby in this country to get maternity services right. No woman should fear for her life or her child’s life because of the colour of her skin or the postcode that she lives in. We have to do better.