Written questions by Ribeiro-Addy.

What steps he plans to take to ensure that (a) all and (b) ethnic minority women have effective access to (i) postnatal care, (ii) mental health support and (iii) support for new mothers.

The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services through all stages of pregnancy and beyond. Measures include making care more personalised and equitable, covering both physical and mental health, and extending postnatal care and support for new mothers.There is now a range of postnatal and mental health support, as well as broader support available for new mothers. For example, all women who have given birth should be offered a check-up with their general practitioner (GP) six to eight weeks after giving birth. The check-up will cover a range of topics such as mental health, physical recovery, breastfeeding, and support with family planning. This check provides an important opportunity for women to be listened to by their GP in a discreet, supportive environment, to provide personalised postnatal care for their physical and mental health.NHS England is also rolling out perinatal pelvic health services and maternal mental health services to support women with the physical and mental impact of birth. Bespoke mental health pathways support women who experience mental health difficulties as a result of labour. These services are provided through specialist perinatal mental health services, maternal mental health services, and mother and baby units.As part of the plan, all local areas have now also published Equity and Equality Action Plans, setting out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and those living in the most deprived areas.

What steps his Department is taking with (a) NHS England and (b) healthcare professionals to ensure that patients from ethnic minority backgrounds are able to discuss any concerns they may have on the potential impact of (i) cultural and (ii) racial bias; and what steps he is taking to improve the experiences of patients who raise those concerns.

The Government recognises that racial health inequalities are linked to broader socioeconomic factors. Tackling these inequalities is central to building a fairer health system where outcomes are not dictated by race or background.Community-led approaches, including peer support and culturally sensitive social prescribing, are integral to preventing poor health outcomes and improving self-management. These will be key features of the upcoming 10-Year Health Plan.The NHS Framework for Action on Inclusion Health is advancing improvements in culturally competent and trauma-informed care, ensuring services are responsive to the needs of ethnic minority groups and other marginalised populations.As raised in last year’s health inequalities public board report, the National Health Service has also established the NHS Race and Health Observatory to better understand and address the stark health inequalities experienced by black and minority ethnic communities. Further information on last year’s health inequalities public board report and the NHS Race and Health Observatory is available, respectively, at the following two links:https://www.england.nhs.uk/long-read/annual-report-on-nhs-englands-work-on-healthcare-inequalities-and-the-nhs-race-and-health-observatory-2/https://www.nhsrho.org/about-us/

What assessment he has made of the adequacy of the quality of maternity care for women from Black and Asian backgrounds.

It is unacceptable that there are inequalities for women and babies. It is a priority for the Government to make sure that all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity. NHS England’s three-year delivery plan for maternity and neonatal services sets out how the National Health Service will make maternity and neonatal care safer, more personalised, and more equitable for women, babies, and families. A central component of this is action to tackle and reduce inequalities, to deliver consistency in access, experiences, and outcomes. Through this plan, all local areas now have Equity and Equality Action Plans in place, which set out tailored interventions that tackle inequalities for women and babies from ethnic backgrounds and those living in the most deprived areas. All trusts are also now implementing Version 3 of the Saving Babies Lives Care Bundle, which provides maternity units with guidance and interventions to reduce stillbirths, neonatal brain injury, neonatal death, and preterm birth. It also includes initiatives to tackle factors that also drive worst outcomes, for example reducing smoking in pregnancy. However, further action is needed, and ministers in the Department are working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change. Part of this will be setting an explicit target to close the black and Asian maternal mortality gap and drive the change we need to see.

What steps he is taking to ensure that ethnic minority women are adequately represented in the development of national maternity care (a) policies and (b) guidelines.

It is unacceptable that there are stark inequalities for women and babies. It is a priority for the Government to make sure that all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity.We recognise the importance of ethnic minority women being adequately represented within the development of policies and guidelines. Maternity and Neonatal Voices Partnerships are one such forum in place that ensures these voices are at the heart of the decisions made in maternity and neonatal services. These partnerships listen to the experiences of women and families, and bring together service users, staff, and other stakeholders to plan, review, and improve maternity and neonatal care. At a local level, 27% of Maternity and Neonatal Voices Partnerships leads are from ethnic minority groups. NHS England has provided support to improve the ethnic diversity of Maternity and Neonatal Voices Partnerships.NHS England also has in place a National Service User Voice Group, which informs the development of national maternity care policies and guidelines. 35% of NHS England’s National Service User Voice Group leads for maternity and neonatal care are from an ethnic minority group.

Whether (a) his Department and (b) the National Institute for Health Research have commissioned (i) research and (ii) evaluation on systemic racism in maternity services.

The Department commissions research through the National Institute for Health and Care Research (NIHR).The NIHR Research Inclusion Strategy 2022-2027 sets out how the NIHR will become a more inclusive funder of research and widen access to participation in clinical trials for under-represented groups such as pregnant women and ethnic minorities. In addition to these priorities, the NIHR will specifically consider intersectionality, recognising that multiple social identities overlap to exacerbate the experience of inequities.The NIHR is actively supporting research to address disparities and improve equity in maternity services, including projects focussed on racism and its impact on maternal health. For example, the NIHR has supported research to understand how multiple inequalities, including racism, shape postnatal mental health among Black Caribbean and Black African women. The NIHR is also funding a study which is undertaking a wider exploration of the harms that health and social care services can cause the African-Caribbean communities in the United Kingdom. This study will explore how health researchers can work more positively with people of African-Caribbean heritage; to start having conversations about the harms that health and social care services can cause to these communities and determine how research and practice in this area can improve.In addition, in March 2024, the NIHR launched a £50 million ‘Challenge’ funding call for research to tackle inequalities in maternity care bringing together experts across the country into a new consortium. The research carried out by the consortium will focus on inequalities before, during and after pregnancy and identify specific areas where measurable improvements can be made.The NIHR continues to welcome funding applications for research into any aspect of maternal health, including research on systemic racism in maternity services.

What steps his Department is taking to help support local maternity services to tackle racial disparities; and whether his Department monitors the compliance of these services with guidelines on (a) equality and (b) anti-discrimination.

The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services by making care more personalised and equitable. A key objective within the plan is to reduce inequalities for all in maternity access, experience, and outcomes, seeking to improve equity for mothers and babies. As part of the plan, all local areas have published Equity and Equality Action Plans, which set out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and those living in the most deprived areas. Equity and Equality Action Plans are published online to ensure public accountability. NHS England has published technical guidance to monitor compliance and to determine the success measures that are used to monitor the outcomes and progress in achieving the key objectives of the plan. The guidance is available at the following link: https://www.england.nhs.uk/long-read/three-year-delivery-plan-for-maternity-and-neonatal-care-technical-guidance/ The Department is also considering what longer term action can be taken to tackle disparities in outcomes and experiences for black, Asian, and minority ethnic women. This includes working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change.

What steps his Department is taking to help ensure that Black, Asian, and other minority ethnic women receive equitable access to high-quality maternity care in (a) areas with significant health inequalities and (b) other areas.

It is unacceptable that there are such inequalities for women and babies. It is a priority for the Government to make sure that all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity. The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services by making care more personalised and equitable. A key objective within the plan is to reduce inequalities for all in maternity access, experience, and outcomes, to improve equity for mothers and babies. As part of the plan, all local areas have published Equity and Equality Action Plans, which set out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and for those living in the most deprived areas. Trusts are also implementing Version 3 of the Saving Babies Lives Care Bundle, which provides maternity units with guidance and interventions to reduce stillbirths, neonatal brain injury, neonatal death, and preterm birth. The Department continues to work closely with the NHS as it delivers these initiatives.The Department is also considering what longer term action can be taken to tackle disparities in outcomes and experiences for black, Asian, and minority ethnic women. This includes working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change.

What steps his Department is taking to (a) ensure that data collection on maternity care outcomes is disaggregated by ethnicity and (b) reduce gaps in this data.

Data on a woman’s ethnic background is routinely collected by services at multiple points throughout maternity care. This data is used to disaggregate reporting of adverse outcomes, like maternal mortality, by ethnicity. Differences by ethnicity are also reported as part of the Care Quality Commission’s annual survey, which asks a sample of pregnant women and new mothers about their experience of National Health Service maternity services.NHS trusts are incentivised to collect this information through the Maternity Incentive Scheme, which is a financial incentive program designed to enhance maternity safety within NHS trusts. Safety Action 2 of the Maternity Incentive Scheme incentivises trusts to submit digital information, including ethnicity data, to the Maternity Services Data Set.The levels of completeness are high, and gaps are rare. 95% of women who gave birth in 2023/24 had their ethnic background recorded.

What steps his Department is taking to ensure that culturally competent (a) midwifery and (b) obstetric training is available in the NHS; and how his Department assesses the effectiveness of these steps.

It is a priority for the Government to make sure that all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity. To deliver this, it is important that those working in maternity and neonatal services receive the required training needed to deliver culturally competent care. While it is the responsibility of employers in the health system to ensure that their staff are trained to the required standards to deliver safe and effective treatment for patients, NHS England is taking steps to ensure that maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and through provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Over 15,400 maternity staff have completed the e-learning module, which supports staff to better understand and meet the needs of diverse communities. NHS England has also embedded equity-focused leadership development through the Perinatal Culture and Leadership Programme. All 150 maternity and neonatal units in England have participated in the programme. No assessment has been made on the effectiveness of these steps.

What steps his Department is taking to help reduce the impact of (a) housing, (b) income, (c) access to education and (d) other social determinants of health on maternal health outcomes for ethnic minority women.

The Government is committed to addressing the stark inequalities for women and babies, so that everyone can receive the high-quality care they deserve regardless of their background, circumstance, or ethnicity.The Department is working with NHS England, other Government departments, and the wider sector to identify and embed the right actions and interventions that will help deliver improvements. For example, we are working closely with the Ministry of Housing, Communities and Local Government to develop non-statutory guidance to support the implementation of Awaab’s Law from October 2025. This law introduces additional hazards, such as excess cold, which increase health risks for pregnant women, as well as for unborn and born children.To find new ways to tackle maternity disparities, the National Institute for Health and Care Research, funded by the Department, launched the first challenge on maternity inequalities in March 2024. Over the subsequent five years, funding of up to £50 million will be made available to develop research and evidence that will drive action to reduce maternity inequalities and improve outcomes for women.

What information his Department holds on the (a) number and proportion of maternity services that use tailored interventions to address the specific needs of ethnic minority groups and (b) effectiveness of tailored interventions in reducing racial disparities in maternal health outcomes.

No national data is collected on the number, proportion, and effectiveness of maternity services that use tailored interventions to address the specific needs of ethnic minority groups. It is, however, expected that all local areas fully implement their Equity and Equality Action Plans, which set out tailored interventions for tackling inequalities for women and babies from ethnic backgrounds and for those living in the most deprived areas.

What steps he is taking to reduce disparities in maternity care outcomes for Black, Asian, and Minority Ethnic women.

It is unacceptable that there are stark inequalities for women and babies, and it is a priority for the Government to make sure all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity. This includes taking action before women reach maternity care, as well as after they go home, with action focusing on improving both women’s experiences and outcomes.The Government is committed to setting an explicit target to close the maternal mortality gap. We are ensuring that we take an evidence-based approach to determining what targets are set, and that any targets set are women and baby-centred.The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services by making care more personalised and equitable. A key objective within the plan is to reduce inequalities for all in maternity access, experience, and outcomes, seeking to improve equity for mothers and babies.As part of the plan, all local areas have published Equity and Equality Action Plans, which set out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and those living in the most deprived areas. Trusts are also implementing Version 3 of the Saving Babies Lives Care Bundle, which provides maternity units with guidance and interventions to reduce stillbirths, neonatal brain injury, neonatal death, and preterm birth. The Department continues to work closely with the NHS as it delivers these initiatives.Maternal Medicine Networks have also been established across England, which provide expert care to women with complex medical conditions before, during, and after pregnancy. To address inequalities in maternal outcomes, networks should put pathways in place to ensure equal access to specialised care for all women, and that referral criteria reflect the increased vulnerability of women from ethnic minorities and those who are socially deprived.The Department is considering what longer term action can be taken to tackle disparities in outcomes and experience for black, Asian, and minority ethnic women. This includes working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change, both immediately, and in the future.

What steps he is taking to help tackle racial disparities in maternal mortality rates.

It is unacceptable that there are stark inequalities for women and babies, and it is a priority for the Government to make sure all women and babies receive the high-quality care they deserve, regardless of their background, location, or ethnicity. This includes taking action before women reach maternity care, as well as after they go home, with action focusing on improving both women’s experiences and outcomes.The Government is committed to setting an explicit target to close the maternal mortality gap. We are ensuring that we take an evidence-based approach to determining what targets are set, and that any targets set are women and baby-centred.The National Health Service’s Three-Year Delivery Plan for Maternity and Neonatal Services sets national measures to improve maternity and neonatal services by making care more personalised and equitable. A key objective within the plan is to reduce inequalities for all in maternity access, experience, and outcomes, seeking to improve equity for mothers and babies.As part of the plan, all local areas have published Equity and Equality Action Plans, which set out tailored interventions that will tackle inequalities for women and babies from ethnic backgrounds and those living in the most deprived areas. Trusts are also implementing Version 3 of the Saving Babies Lives Care Bundle, which provides maternity units with guidance and interventions to reduce stillbirths, neonatal brain injury, neonatal death, and preterm birth. The Department continues to work closely with the NHS as it delivers these initiatives.Maternal Medicine Networks have also been established across England, which provide expert care to women with complex medical conditions before, during, and after pregnancy. To address inequalities in maternal outcomes, networks should put pathways in place to ensure equal access to specialised care for all women, and that referral criteria reflect the increased vulnerability of women from ethnic minorities and those who are socially deprived.The Department is considering what longer term action can be taken to tackle disparities in outcomes and experience for black, Asian, and minority ethnic women. This includes working closely with NHS England, and the wider sector, to identify the right actions and interventions that will deliver the required change, both immediately, and in the future.

What assessment he has made of the potential impact of racial disparities in maternity care on the mental health and wellbeing of women from ethnic minority communities.

The Government recognises that women from ethnic minority backgrounds may face unique challenges when it comes to maternal mental health, and that perinatal mental health difficulties commonly affect both women and men, and can adversely impact parent-infant relationships.Significant progress has been made to ensure that women experiencing moderate to severe and complex perinatal mental health problems can access specialist perinatal mental health services. For example, mental health services are now available for women who have pre-existing mental health needs prior to their pregnancy, as well as for those who experience mental health difficulties during or as a result of their pregnancy or labour. This is delivered through specialist perinatal mental health services, maternal mental health services, and Mother and Baby Units. Work is also ongoing to modernise the Mental Health Act so that it is fit for the 21st century, redressing the balance of power from the system to the patient, and ensuring that people with the most severe mental health conditions get better, more personalised care.No overall assessment has been made on the potential impact of racial disparities in maternity care on the mental health and wellbeing of women from ethnic minority communities.

What steps he is taking to ensure that ethnic minority women are adequately represented in research on maternity care.

The Department commissions research through the National Institute for Health and Care Research (NIHR). The NIHR’s Research Inclusion Strategy 2022-2027 sets out how NIHR will become a more inclusive funder of research and widen access to participation in clinical trials for under-represented groups, such as pregnant women and ethnic minorities. In addition to these priorities, the NIHR will specifically consider intersectionality, recognising that multiple social identities overlap to exacerbate the experience of inequities.In March 2024, the NIHR launched a £50 million ‘Challenge’ funding call for research to tackle inequalities in maternity care, bringing together experts from across the country into a new consortium. The research carried out by the consortium will focus on inequalities before, during, and after pregnancy, and will identify specific areas where measurable improvements can be made.Furthermore, the NIHR is currently funding two studies focussed on ensuring ethnic minority women are adequately represented in research on maternity care. The first aims to co-produce a toolkit or guidance which can be used to improve the inclusion of women from ethnic minority backgrounds in maternity research. The second aims to develop a guide to support research nurses and midwives to effectively communicate maternal and neonatal healthcare research opportunities to back women.The NIHR continues to welcome funding applications for research into any aspect of maternal health, including research on improving the representation of women from ethnic minority backgrounds in research on maternity care.

What steps he is taking to ensure that maternity healthcare professionals receive training on (a) unconscious bias and (b) culturally competent care.

Taking action to tackle racism experienced by both staff and patients is essential to providing safe services for everyone. It is right that the National Health Service takes proactive steps to address prejudice and discrimination where it exists across the NHS workforce.NHS England is ensuring maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and the provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Equity-focused leadership development is being embedded through the national Perinatal Culture and Leadership Programme.In June 2023, NHS England published an Equality, Diversity and Inclusion Improvement Plan, which sets out targeted actions to address prejudice and discrimination in the NHS workforce. The plan seeks to increase accountability for all leaders in delivering improvements, and to create an environment that eliminates the conditions in which bullying, discrimination, harassment, and physical violence at work occur.For maternity services specifically, all local areas, including those in urban and rural areas, are required to equip staff to provide culturally competent care through their local Equity and Equality Actions plans, such as by providing appropriate training to staff for their local population.   NHS England is also developing a respectful and inclusive maternity care toolkit which aims to improve access, experiences, and outcomes for service users and to support staff to provide culturally sensitive care.

What steps he is taking to improve access to culturally appropriate maternity care for women from diverse ethnic backgrounds in (a) urban and (b) rural areas.

Taking action to tackle racism experienced by both staff and patients is essential to providing safe services for everyone. It is right that the National Health Service takes proactive steps to address prejudice and discrimination where it exists across the NHS workforce.NHS England is ensuring maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and the provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Equity-focused leadership development is being embedded through the national Perinatal Culture and Leadership Programme.In June 2023, NHS England published an Equality, Diversity and Inclusion Improvement Plan, which sets out targeted actions to address prejudice and discrimination in the NHS workforce. The plan seeks to increase accountability for all leaders in delivering improvements, and to create an environment that eliminates the conditions in which bullying, discrimination, harassment, and physical violence at work occur.For maternity services specifically, all local areas, including those in urban and rural areas, are required to equip staff to provide culturally competent care through their local Equity and Equality Actions plans, such as by providing appropriate training to staff for their local population.   NHS England is also developing a respectful and inclusive maternity care toolkit which aims to improve access, experiences, and outcomes for service users and to support staff to provide culturally sensitive care.

What steps he is taking to ensure that maternity services (a) are free from racial discrimination and (b) effectively meet the needs of women from all ethnic backgrounds.

Taking action to tackle racism experienced by both staff and patients is essential to providing safe services for everyone. It is right that the National Health Service takes proactive steps to address prejudice and discrimination where it exists across the NHS workforce.NHS England is ensuring maternity healthcare professionals receive training on unconscious bias and culturally competent care through the Core Competency Framework and the provision of the Cultural Competence and Cultural Safety in Maternity Services e-learning course. Equity-focused leadership development is being embedded through the national Perinatal Culture and Leadership Programme.In June 2023, NHS England published an Equality, Diversity and Inclusion Improvement Plan, which sets out targeted actions to address prejudice and discrimination in the NHS workforce. The plan seeks to increase accountability for all leaders in delivering improvements, and to create an environment that eliminates the conditions in which bullying, discrimination, harassment, and physical violence at work occur.For maternity services specifically, all local areas, including those in urban and rural areas, are required to equip staff to provide culturally competent care through their local Equity and Equality Actions plans, such as by providing appropriate training to staff for their local population.   NHS England is also developing a respectful and inclusive maternity care toolkit which aims to improve access, experiences, and outcomes for service users and to support staff to provide culturally sensitive care.

What data his Department collects on the (a) racial and (b) ethnic backgrounds of women experiencing adverse maternity outcomes; and how that data is used to inform policy on maternity care services.

Monitoring and utilising data and evidence is crucial to making evidence-based improvements to our maternity services. Data collected on the ethnic backgrounds of women experiencing adverse maternity outcomes can help identify areas that require targeted interventions and improvements in maternal and neonatal care. Monitoring the incidence and rate of adverse outcomes is a crucial step in implementing evidence-based strategies to preventing and mitigating such incidents.Data on a woman’s ethnic background is collected by services at various points on her maternity journey. National Health Service trusts are incentivised to collect this information, and levels of completeness are high, with 95% of women who gave birth in 2023/24 having had their ethnic group recorded. This information is used to identify differences in care pathways and outcomes experienced by women from different ethnic backgrounds.For example, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) reports the shocking disparity in maternal mortality rates for black and Asian women compared with white women. MBRRACE-UK has also performed a confidential enquiry into the care of black and Asian women who have experienced a stillbirth or neonatal death. These reviews include recommendations for improvements in clinical processes and policy that may reduce ethnic inequalities in adverse maternity outcomes.Monitoring the experiences women have of different aspects of maternity care is also crucial. The Care Quality Commission conducts an annual survey that asks pregnant women and new mothers about their experience of NHS maternity services. The 2024 survey found that women who reported their ethnicity as ‘Indian’, ‘Pakistani’ and ‘any other White background’ reported poorer experiences of maternity care, specifically around not feeling listened to and not receiving help during their antenatal and postnatal care. These insights inform local and national interventions.

What steps his Department is taking to (a) monitor and (b) reduce racial disparities in the (i) experiences, (ii) levels of satisfaction and (iii) care outcomes of women during (A) antenatal, (B) labour and (C) postnatal care.

Monitoring and utilising data and evidence is crucial to making evidence-based improvements to our maternity services. Data collected on the ethnic backgrounds of women experiencing adverse maternity outcomes can help identify areas that require targeted interventions and improvements in maternal and neonatal care. Monitoring the incidence and rate of adverse outcomes is a crucial step in implementing evidence-based strategies to preventing and mitigating such incidents.Data on a woman’s ethnic background is collected by services at various points on her maternity journey. National Health Service trusts are incentivised to collect this information, and levels of completeness are high, with 95% of women who gave birth in 2023/24 having had their ethnic group recorded. This information is used to identify differences in care pathways and outcomes experienced by women from different ethnic backgrounds.For example, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) reports the shocking disparity in maternal mortality rates for black and Asian women compared with white women. MBRRACE-UK has also performed a confidential enquiry into the care of black and Asian women who have experienced a stillbirth or neonatal death. These reviews include recommendations for improvements in clinical processes and policy that may reduce ethnic inequalities in adverse maternity outcomes.Monitoring the experiences women have of different aspects of maternity care is also crucial. The Care Quality Commission conducts an annual survey that asks pregnant women and new mothers about their experience of NHS maternity services. The 2024 survey found that women who reported their ethnicity as ‘Indian’, ‘Pakistani’ and ‘any other White background’ reported poorer experiences of maternity care, specifically around not feeling listened to and not receiving help during their antenatal and postnatal care. These insights inform local and national interventions.