A new report from MBRRACE-UK today highlights the need to improve access to maternity services for migrant women who do not speak English
The latest MBRRACE-UK Confidential Enquiry shows that migrant women who have recently arrived in the UK face many barriers to accessing the care they and their babies need during pregnancy and soon after birth.
The report found that 2 out of 3 (68%) babies from this group might have been saved if the care they received were of a higher standard. Crucially, only 4% of the group had care that was graded as ‘good’.
Migrant families often have multiple vulnerabilities, and research shows they can experience challenges in accessing the maternity and neonatal services they need. With 1 in 3 live births in the UK in 2022 being to women who were not born in the UK, it is vital to understand how to make care safer for all families.
“The confidential enquiry published today highlights clear issues about the lack of provision and use of interpreting services. This is a recurring issue - numerous reports have highlighted instances of avoidable harm in maternity services that are associated with language barriers. NICE guidance states that women should be provided with an interpreter who can communicate in her preferred language, but in 50% of the contacts reviewed by MBRRACE there was no documented interpreter provision.
"The Sands and Tommy’s Joint Policy Unit has recently published a briefing on the topic, setting out where action is needed to make progress. Through the Maternity Consortium we are actively working to gain further insight from service users and healthcare professionals into the quality and use of interpreting services. Ensuring consistent provision of these services is vital to help ensure everyone has access to the care they need and to save more babies’ lives.”
Robert Wilson, Head of Sands and Tommy’s Joint Policy Unit
Key areas of concern:
- Interpreting services are a major area of concern: almost all the women needed an interpreter, yet 3 in 4 of the contacts they had with maternity services took place without a professional interpreter.
- Though women in this group often had harsh experiences and faced serious social issues, only half of the women were invited to talk about mental health issues during their pregnancy.
- Recently arrived women were unfamiliar with what to expect from maternity care in the UK or what they should do to access care, meaning that many women missed out on tests and monitoring that they needed, or went to the wrong place to get help in an emergency.
“I remember not getting any information about Rylan's care, I was just waiting and no one was talking to me. There were things I was not being told that other families were being told. I felt like nobody sat me down because maybe people thought that I wouldn't understand.
Sometimes people assume either that you can't speak English or that you do not understand or that you're illiterate. I would have appreciated if somebody could have looked into my care plan and understand that sitting me down and discussing Rylan's care plan would have gone a long way.”
Vongayi Mufara, Rylan’s mother
The recommendations
As part of MBRRACE-UK, Sands supports the enquiry’s recommendations to:
- Provide interpreting services in different situations (particularly when trying to obtain consent)
- Advocate to help pregnant women who are newly arrived in the UK or have language barriers, to help them get the care they need
- Ensure that the number of women who require language support, and the support provided at each visit, is recorded systematically
- Personalise approaches to care, including opportunities to refer pregnant women into maternity by routes other than self-referral through a GP
- Introduce more conversations during pregnancy about mental health
- Support research to understand women’s and healthcare professionals’ views on the barriers and facilitators to accessing and navigating maternity and neonatal care for women in this group.
Sands is working with the organisation Amma Birth Companions, which provides vital services to support women and birthing people from migrant backgrounds during pregnancy and childbirth. Together we are ensuring all parents voices are heard, including those from migrant backgrounds.
“Our work has highlighted how systemic racism, inadequate communication, limited choice, and a lack of person-centred care negatively affects the birth experiences of women who already face multiple inequities.
“Testimonies have highlighted that language barriers further exacerbate these inequalities, with many people not being provided with adequate interpreting, and instead being asked to rely on tools like Google Translate, leading to critical information being miscommunicated. In these cases, women are left feeling unsafe, unsupported and disempowered during some of the most vulnerable moments of their lives.”
Maree Aldam, CEO of Amma Birth Companions
How Sands is helping
With the help of our supporters, Sands is working on multiple areas to better understand this issue and push for change from decision-makers.
Sands is part of MBRRACE-UK (Mothers and Babies Reducing Risk through Audit and Confidential Enquires), a collaboration of researchers from Oxford and Leicester universities. The group is commissioned by the NHS to collect and analyse hospital data on stillbirths and neonatal deaths across the UK. Sands plays a key role as part of this collaboration, making sure that parents’ needs are reflected in research, supporting learning that could lead to fewer baby deaths.
The Sands and Tommy’s Joint Policy Unit, which is focused on working together to achieve policy changes that will save more babies’ lives, is also doing key work in this area. Our recent briefing highlights issues with the use and quality of interpreting and translation services in maternity care, which contribute to poor outcomes and avoidable harm.
As part of the Maternity Consortium, we are actively working to gain further insight from service users and healthcare professionals into the quality and use of interpreting services.
Get the full report from MBRRACE-UK.
Support for you
Sands is here for anyone affected by pregnancy loss or the death of a baby, however recently or longer ago, for as long as they need this.