Equitable and Improved Outcomes Throughout Pregnancy and the Neonatal Period

Motion as passed

Conference notes that:

1. Despite healthcare advancements, significant gaps exist in access to quality maternal care, resulting in persistent inequalities across ethnicities and in more economically deprived communities.
2. The complexities of women giving birth have dramatically increased since the 1970s which has led to increased risk to women, significantly increased workloads for healthcare professionals especially midwives and an increased burden on the wider aspects of the health service.
3. The method for measuring maternity services (and therefore its requirements) has been in place since the inception of the NHS, is inaccurate as it is currently based solely on the number of women birthing at a location, ignores the volume and variety of increase to healthcare workloads as well as the complexity of mums and babies accessing care; A significant gap therefore exists in understanding the real resolution to many birthing challenges across the landscape.
4. 49% of maternity services are rated as 'inadequate' or 'requires improvement' by the Care Quality Commission.
5. The true scale of miscarriage in the UK is unknown because no official record of miscarriages is held.
6. The national ambition set in 2010 to reduce stillbirths, neonatal, and maternal deaths by 50% by 2025 is nearing its expiry, but we are not on track to meet the target.
7. The 2022 MBRRACE-UK report demonstrated that Black women are at almost four times greater risk of maternal mortality than White women.
8. Unconscious bias influences medical care and bedside manner, putting Black and Black mixed women at higher risk, and a lack of knowledge hinders the identification and diagnosis of conditions that are specific to and disproportionately affect Black and Black mixed women.
9. There are numerous issues regarding incomplete and inaccurate ethnicity data collection in healthcare, creating barriers when evaluating progress on equity in healthcare.
10. Black babies are nearly twice as likely, and Asian babies are nearly 1.5 times more likely, to die during the first 28 days compared to White babies.
11. A Birthrights' inquiry uncovered testimony that "Black, Brown and Mixed ethnicity women and birthing people's pain [is commonly] ignored or denied, and pain relief [is] withheld due to staff not believing they were in labour".
12. Trans and non-binary people report that they are met with less dignity and respect when accessing obstetric services.
13. Infant mortality rates in the most deprived neighbourhoods are double those in the least deprived areas.
14. The 2019 NHS Staff Survey records that 40.3% of midwives reported feeling unwell due to work-related stress in the previous 12 months and 63.7% had continued to work despite not feeling well enough to perform their duties.
15. Of every £1 spent on maternity care in the NHS, only 1p is spent on pregnancy research.

Conference believes that:

1. The UK must strive to become the safest place in the world to have a baby.
2. Addressing disparities in obstetric care is essential for a fair society.
3. The UK must work towards ending discrimination towards diverse parents during pregnancy.

Conference therefore calls for:

1. The UK Government to renew the national maternity ambitions beyond 2025, to include the four nations, and to enhance them with a clear baseline to measure progress against.
2. Modernisation of the way maternity services are measured including use of women’s birthing complexity (Dependency Score), volume and variety of healthcare professional workloads and improved reporting to determine maternity services priorities.
3. Referral to NHS mental health support services to be made available after every miscarriage, not just after three, and for a report on mental health service waiting times for these patients to be published annually.
4. Anyone experiencing miscarriage to have access to best-practice care 24 hours a day, 7 days a week.
5. All miscarriages to be recorded so that the problem is no longer hidden, national targets can be set, and the impact of interventions can be measured, in line with requests from Sands and Tommy's Joint Policy Unit.
6. Coding of ethnicity and data to be improved, surveys should avoid overusing 'other' as a category and provide a text box for people to explain what 'other' means for them, and Black and Black mixed should be clearly defined.
7. A welcoming and inclusive environment for everyone receiving maternity or perinatal care, including trans and nonbinary people.
8. The UK Government to ensure that the commitments made in the Workforce Plan are backed by adequate funding and include expansion of the wider maternity and neonatal workforce.
9. The implementation of the Women and Equalities Committee's recommendation that there should be a cross-Government target and strategy, led by the Department of Health and Social Care, for eliminating maternal health disparities.
10. The Government to publish annual reports on progress in reducing miscarriage and stillbirth rates among ethnic minorities.
11. Interpreters for those whose first language is not English must be available when the expectant mother is with health professionals.

Applicability: England only; except 1. (lines 49-51), which is Federal.

Motion before amendment

Submitted by: Liberal Democrat Women
Mover: Donna Harris
Summation: Helen Morgan MP

Conference notes that:

1. Despite healthcare advancements, significant gaps exist in access to quality maternal care, resulting in persistent inequalities across ethnicities and in more economically deprived communities.
2. 49% of maternity services are rated as 'inadequate' or 'requires improvement' by the Care Quality Commission.
3. The true scale of miscarriage in the UK is unknown because no official record of miscarriages is held.
4. The national ambition set in 2010 to reduce stillbirths, neonatal, and maternal deaths by 50% by 2025 is nearing its expiry, but we are not on track to meet the target.
5. The 2022 MBRRACE-UK report demonstrated that Black women are at almost four times greater risk of maternal mortality than White women.
6. Unconscious bias influences medical care and bedside manner, putting Black and Black mixed women at higher risk, and a lack of knowledge hinders the identification and diagnosis of conditions that are specific to and disproportionately affect Black and Black mixed women.
7. There are numerous issues regarding incomplete and inaccurate ethnicity data collection in healthcare, creating barriers when evaluating progress on equity in healthcare.
8. Black babies are nearly twice as likely, and Asian babies are nearly 1.5 times more likely, to die during the first 28 days compared to White babies.
9. A Birthrights' inquiry uncovered testimony that "Black, Brown and Mixed ethnicity women and birthing people's pain [is commonly] ignored or denied, and pain relief [is] withheld due to staff not believing they were in labour".
10. Trans and non-binary people report that they are met with less dignity and respect when accessing obstetric services.
11. Infant mortality rates in the most deprived neighbourhoods are double those in the least deprived areas.
12. The 2019 NHS Staff Survey records that 40.3% of midwives reported feeling unwell due to work-related stress in the previous 12 months and 63.7% had continued to work despite not feeling well enough to perform their duties.
13. Of every £1 spent on maternity care in the NHS, only 1p is spent on pregnancy research.

Conference believes that:

1. The UK must strive to become the safest place in the world to have a baby.
2. Addressing disparities in obstetric care is essential for a fair society.
3. The UK must work towards ending discrimination towards diverse parents during pregnancy.

Conference therefore calls for:

1. The UK Government to renew the national maternity ambitions beyond 2025, to include the four nations, and to enhance them with a clear baseline to measure progress against.
2. Support and referral to be available after every miscarriage, not just after three.
3. Anyone experiencing miscarriage to have access to best-practice care 24 hours a day, 7 days a week.
4. All miscarriages to be recorded so that the problem is no longer hidden, national targets can be set, and the impact of interventions can be measured, in line with requests from Sands and Tommy's Joint Policy Unit.
5. Coding of ethnicity and data to be improved, surveys should avoid overusing 'other' as a category and provide a text box for people to explain what 'other' means for them, and Black and Black mixed should be clearly defined.
6. A welcoming and inclusive environment for everyone receiving maternity or perinatal care, including trans and nonbinary people.
7. The UK Government to ensure that the commitments made in the Workforce Plan are backed by adequate funding and include expansion of the wider maternity and neonatal workforce.
8. The implementation of the Women and Equalities Committee's recommendation that there should be a cross-Government target and strategy, led by the Department of Health and Social Care, for eliminating maternal health disparities.

Applicability: England only; except 1. (lines 49-51), which is Federal.

Amendments

Amendment One

PASSED

Submitted by: Southwark
Mover: Humaira Ali
Summation: Rachel Bentley

After i) (line 6), insert:

ii) The complexities of women giving birth have dramatically increased since the 1970s which has led to increased risk to women, significantly increased workloads for healthcare professionals especially midwives and an increased burden on the wider aspects of the health service.

iii) The method for measuring maternity services (and therefore its requirements) has been in place since the inception of the NHS, is inaccurate as it is currently based solely on the number of women birthing at a location, ignores the volume and variety of increase to healthcare workloads as well as the complexity of mums and babies accessing care; A significant gap therefore exists in understanding the real resolution to many birthing challenges across the landscape.

After 1. (line 52), insert:

2. Modernisation of the way maternity services are measured including use of women’s birthing complexity (Dependency Score), volume and variety of healthcare professional workloads and improved reporting to determine maternity services priorities.

Amendment Two

PASSED

Submitted by: LDCRE
Mover: Dr Mohsin Khan.
Summation: Lee Dargue.

Delete 2. (lines 52–53) and insert:

2. Referral to NHS mental health support services to be made available after every miscarriage, not just after three, and for a report on mental health service waiting times for these patients to be published annually.

After 8. (line 73), insert:

9. The Government to publish annual reports on progress in reducing miscarriage and stillbirth rates among ethnic minorities.

Amendment Three

PASSED

Submitted by: Liberal Democrat Christian Forum

After 8. (line 73), insert:

8. Interpreters for those whose first language is not English must be available when the expectant mother is with health professionals.

­

Mover: 7 minutes; summation of motion and movers and summation of any amendments: 4 minutes; all other speakers: 3 minutes. For eligibility and procedure for speaking in this debate, see page 8 of the agenda. 

The deadline for amendments to this motion, see pages 10–11, and for requests for separate votes, see pages 7–8 of the agenda, is 09.00 Thursday 12 September. Those selected for debate will be printed in Conference Extra and Saturday’s Conference Daily.