This report from the National Maternity and Perinatal Audit assesses care inequalities using data from births between 1 April 2015 and 31 March 2018 across England, Scotland and Wales.
The National Maternity and Perinatal Audit (NMPA) is led by the Royal College of Obstetricians and Gynaecologists (RCOG) in partnership with the Royal College of Midwives (RCM), the Royal College of Paediatrics and Child Health (RCPCH) and the London School of Hygiene and Tropical Medicine (LSHTM).
The report compares data on women and birthing people:
- living in the most deprived and the least deprived areas in Great Britain.
- from ethnic minority groups and white ethnic groups.
It demonstrates differences between these groups in outcomes of maternity and perinatal care among women and birthing people, and their babies.
- Women from South Asian and Black ethnic groups and those from the most deprived areas had higher rates of hypertension and diabetes when compared with women from white ethnic groups and those in the least deprived areas.
- Smoking was considerably higher among white ethnic groups and those in the most deprived quintile.
- Women from Black ethnic groups had a higher rate of experiencing a birth without intervention.
- Rates of caesarean birth (both elective and emergency combined) and rates of emergency caesarean birth were highest for women from Black ethnic groups and higher for women from South Asian groups when compared with those from white ethnic groups.
- Women and birthing people from Black ethnic groups had higher rates of major postpartum haemorrhage (1500 ml or more) when compared with those from white ethnic groups.
- In contrast to the usual association of increased deprivation with increased morbidity, there was a decreasing trend for major postpartum haemorrhage (1500 ml or more) from the least to most deprived.
- Babies born to women from South Asian ethnic groups were less likely to have an Apgar score of less than 7 at 5 minutes but were more likely to be admitted to a neonatal unit at term when compared with babies born to women from white ethnic groups.
- Babies born to women from Black ethnic groups were more likely to be assessed as having an Apgar score of less than 7 at 5 minutes and were more likely to be admitted to a neonatal unit at term when compared with babies born to women from white ethnic groups.
- Rates of receiving breast milk at their first feed were significantly lower for babies born to white women and to those living in the most deprived areas.
The report also found that data was not always complete, with 1 in 10 women and birthing people in Great Britain (1 in 5 in Scotland) not having their ethnic group recorded, and 6% missing Index of Multiple Deprivation data.