A major review of NHS performance has described maternity care as ‘an important area of concern’, underlining the ‘huge inequalities’ that affect women and birthing people and their babies.
The review by former Health Minister Lord Darzi, published today (September 12) concludes that overall, the NHS is in ‘serious trouble’.
It says public satisfaction with the NHS is at an all-time low, although NHS staff are doing their best to cope with enormous challenges.
On maternity care, Lord Darzi says there have been positive developments in reducing stillbirths and a small decrease in neonatal mortality.
But, his report says, maternal deaths have increased since the pandemic, including when adjusted for the direct impact of Covid-19.
In a speech responding to Lord Darzi’s review, Prime Minister Keir Starmer said the NHS must ‘reform or die’ and promised ‘major surgery not sticking plasters’.
Kath Abrahams, Chief Executive of Tommy’s, said:
“Today’s review of NHS performance highlights issues affecting maternity and neonatal services that are frustrating, upsetting and - sadly – unsurprising.
“As we have said consistently, too many women and birthing people and their babies are being let down by a system in which lessons are not learned, targets for improvement remain unmet and there are ongoing inequities in rates of baby loss by ethnicity and deprivation.
“It is unacceptable that Black women in the UK are still almost three times as likely as White women to die in childbirth. The rate of neonatal death in the most deprived communities is more than double that in the least deprived, and among babies of Black and Asian ethnicity more than 50% higher than for White babies.
“There is evidence and information already available to the NHS that could make pregnancy and childbirth safer for everyone and improve care for those affected by pregnancy loss.
“A prime example is Tommy’s graded model of miscarriage care, which would ensure women and birthing people no longer have to wait until they’ve experienced three consecutive miscarriages before they have access to specialist care.
“We need a truly collaborative response to Lord Darzi’s report. It’s vital that the Government listens to the expertise and experience of NHS clinicians, managers and service users to ensure positive and lasting change and avoid the damaging legacy of previous reforms.”
Lord Darzi’s review says although an increasing proportion of births are defined as ‘complex’ - for example, because of the rising average age at which women are having babies – the overall number of births has fallen and the overall number of midwives has risen over the last ten years.
Even when high levels of staff sickness are taken into account, the review says, ‘capacity alone does not appear to be the constraint on improvement'.
Lord Darzi concludes: “This suggests that a deeper conversation needs to be had on skills, staffing mix, clinical models, leadership and culture in maternity services.”
