Publication of Report: Inequalities in Access to Maternity Services.

House of Commons Health Committee, 7 Millbank, London SW1P 3JA Tel: 020 7219 6182
PRESS NOTICE 23 July 2003 No. 37 Session 2002-03

Although childbirth is now safer than ever before, some women still go without the kind of advice and support that they need, throughout and after their pregnancies, to secure the best possible health outcomes for themselves and for their babies. In December 2002 the Health Committee appointed a sub-committee to undertake a series of short inquiries in this area. In its first inquiry the sub-committee set out to look at the services available to women in England today and at the variation in these services across the country. In conducting its second inquiry, into inequalities in access to maternity services, the sub-committee chose a range of disadvantaged groups of women in order to explore a number of access problems and solutions, and to attempt to draw together some common factors which might contribute to full access to appropriate care and advocacy services. In its third and final inquiry, into choice in maternity services, the sub-committee examined the degree of choice and control a woman has over her maternity care.

Current Membership of the Health Committee:

Mr David Hinchliffe MP (Chairman) [L] Wakefield
Mr David Amess MP [C] Southend West
John Austin MP [L] Erith and Thamesmead
Andy Burnham MP [L] Leigh
Mr Simon Burns MP [C] Chelmsford West
Paul Burstow MP [LD] Sutton and Cheam
Jim Dowd MP [L] Lewisham West
Julia Drown MP [L] South Swindon
Siobhain McDonagh MP [L] Mitcham and Morden
Dr Doug Naysmith MP [L] Bristol North West
Dr Richard Taylor MP [IND] Wyre Forest
Sandra Gidley MP [LD] Romsey was a Member of the Health Committee when it conducted its inquiry into Inequalities in Access to Maternity Services.

The Health Committee is a Select Committee of the House of Commons. It is appointed under Standing Order No. 152 to examine the expenditure, administration and policy of the Department of Health and associated public bodies. The Committee has power to send for persons, papers and records. The Maternity Services Sub-committee, which was nominated on 12 December 2002, is appointed under Standing Order No. 152 and had the power to send for persons, papers and records.

Julia Drown MP, Chair of the Maternity Services Sub-committee said: We undertook this inquiry because we knew that pregnancy outcomes for mothers and babies differed according to people's backgrounds. For example, the maternal death rate amongst unemployed families is 20 times higher than that for women in the highest two social classe,s and a disproportionate number of women from the travelling community die in childbirth or shortly afterwards. The babies of disadvantaged women are more likely to be born with low birth weights.

We saw some examples of excellent practice in meeting the needs of disadvantaged groups - some of which were directly attributable to Government initiatives such as Sure Start - but it was clear to us that the development and implementation of good practice was generally achieved by particular individuals or teams who acted on their own initiative in response to need in their local areas. It was also clear to us that this good practice was rarely shared across the health service. This is deeply disappointing because it means that families across the country are not getting access to the services that they need, and that instigating good practice in different areas involves wasteful duplication of effort by the NHS. In particular we were shocked to hear that in many parts of the country there were insufficient numbers of specialist Mother and Baby Units for women suffering from severe mental health problems after the birth of their babies.

We were also frustrated that after the recommendations of our predecessor committee, and those of Changing Childbirth, so little progress had been made towards fulfilling the needs of women and families affected by disabilities. We identified problems with access to interpreting services, for people who do not speak English as their first language, and for those who are deaf. We are concerned that too many maternity services depend on relatives to interpret, which may be appropriate in some circumstances but not in others. For women who are subject to domestic violence, relying on partners to interpret can conceal the problem, and may ultimately be extremely dangerous.

Throughout our inquiry we heard that women's experiences of maternity care varied a great deal according to the attitude of individual members of maternity care staff. Prejudice in relation to class, race, or disability profoundly affected a woman's experience of pregnancy, birth and motherhood. Staff who care for families at such an important and sensitive time must have access to specialised training and support in these issues. Across the NHS, maternity services for different groups can only be described as patchy. We urge the Government in our report to address the inequalities in services so that every woman, whatever her background, can be assured of high quality services.

Copies of the reports will be available for collection on Wednesday 23 July at 11am from the reception desk at Westminster House, 7 Millbank, London SW1, and available to the Press at the Press Gallery, House of Commons. Following publication, copies will be on sale from the usual Stationery Office outlets (tel. 0845 702 3473) and the Parliamentary Bookshop (tel. 020 7219 3890).