For mothers more than a quarter of the 600,000 infants born each year throughout England or Wales are mothers from ethnic minorities. The Confidential Enquiry into Maternal Mortality revealed that from 2016-18 when compared with their white counterparts, the rate of women who die within a period of up to one year following pregnancy is nearly four times higher for women of African descent and more than twice as high for Asian women. The evidence is unmistakable: mothers of ethnic minorities tend to be killed during birth than their white counterparts within the UK.
As people become more aware of different health outcomes for people of different ethnicities and products, this is now an important area of health policy and likely to gain popularity in the coming years. This article will explore why these differences exist, the current policy addressing this imbalance, and future policy recommendations. Suggested reasons for the disparity
These disparities aren’t restricted to maternal health outcomes. For almost all health outcomes, ethnic minorities, specifically of African descent, and South Asians, suffer the most. Individuals of African descent have an elevated risk of being detained in the health law context than white people. COVID-19 is disproportionately affecting those who belong to ethnic minorities. Twenty-five percent of patients that required assistance with their care were from a black or Asian background. Black or Asian patients suffering from COVID-19 have the highest mortality rate. This implies that a myriad of factors causes inequalities among different groups of people. There is evidence of racism being the primary cause and cause of adverse health outcomes due to health inequities. Both on a social and personal level, this has more and less obvious impacts on an individual’s health.
In particular, the minority ethnic groups within the UK are a vital factor of health outcomes that differ. This leads to different access to opportunities in the community across various fields, including education, health, and the job market. In England, the least vulnerable ethnic minorities are more likely to be found in the areas with the highest poverty levels. Nine percent of white British inhabitants reside in the poorest areas compared to 31 percent of Pakistani and 28 percent of Bangladeshi and 20 percent of people of black African and 18 percent of African-American and black Caribbean people. The lack of healthcare services and insufficient health education can compound and lead to poor maternal health outcomes.
Another aspect that could result in adverse health outcomes is the discrimination of healthcare medical professionals. A study in the US discovered that minorities from ethnic minorities often received less healthcare than white populations. White patients are twice as likely to get pain relief as Hispanic patients. The discrimination in how different ethnic groups are treated in the healthcare system is seen across various outcomes for health. In the UK, 54 percent Of doctors have white, and 60percent of doctors of white heritage. There is a glaring lack of ethnic diversity within the medical profession, particularly in their work’s top tiers. Medical professionals that reflect the communities they serve are vital to enable women to get treated in a manner that’s appropriate to their culture and sensitivity. The impact of these many elements has led to the creation notion of “weathering.” This model explores the idea that being subject to discrimination and physical, psychological and mental stressors harm health and accelerate ageing, which could explain why black women’s health declines sooner than white women’s. The disparity in mortality rates for mothers is not due to any one thing and is the result of multiple stresses, with particular being more evident than others. Previous strategies for policy
The systemic issues that have been recognized need structural reforms and policies throughout all aspects of life, including housing, education, and criminal justice. The disparities between ethnicities in maternal health have led to the publication of a range of recommendations and reports in the past, but with little progress.
Maternity care was a top priority for subsequent NHS plan forwards. One of the forward-looking views in 2015 led to better Births Improved outcomes for maternal services in England. The report has established the direction for future news, focusing on improving healthcare quality as the principal health policy suggestion. It didn’t contain any specific data concerning mortality rates for mothers and did not include any particular recommendations for mothers belonging to diverse ethnic backgrounds.
The NHS long-term plan, published in 2019, set a goal to reduce 50% in maternal mortality, neonatal stillbirth mortality, and severe brain injuries in 2025′. There was also no clear commitment to decrease ethnic differences in maternal deaths instead of focusing on mothers’ mortality as a whole. Examining the progress made on better birth outcomes in 2020 found that maternal mortality rates are higher for ethnic minority groups. The plan also established clear targets for rolling the continuity of healthcare for BME groups. However, they once could not set an exact target for reducing the disparity in mortality rates between ethnic groups.
The primary focus of the government’s strategy to combat the issue of maternal mortality is through the improvement of the continuity of care model, which was previously discussed. It is a midwife-led initiative that ensures that every pregnant woman develops a connection with her midwife and guarantees a named midwife. There is an evidence-based basis in the UK for using this model. A Cochrane analysis of systematic review concluded that it reduced the risk of premature birth and preterm death in comparison to conventional care. Still, there were no reports of outcomes related to maternal mortality. Additional research on the effect of this model, which is led by a midwife, on maternal mortality is necessary and its contribution to decreasing ethnic disparities in maternal mortality. The government’s Commission on Race and Ethnic Disparities was widely criticized because of its lack of understanding of structural issues, suggesting an attempt to shift on the issues discussed in this piece, emphasizing personal and individual aspects as the main reason behind the disparities regarding health-related outcomes. This method fails to recognize the underlying factors that need to be addressed to stop the health outcomes of BME mothers from falling further than the white British mothers.
In the end, it is suggested that the government consider making clear targets to reduce the maternal mortality rate of ethnic minorities disparity and ask the CQC to consider specifically the different outcomes to ethnicity.