MBRRACE-UK: State of the nation report on the care of recent migrant women with language barriers who have experienced a stillbirth or neonatal death (12 December 2024)

Summary

The Maternal, Newborn and Infant Clinical Outcome Review Programme has published an MBRRACE-UK Perinatal Confidential Enquiry report on the care of recent migrant women with language barriers who have experienced a stillbirth or neonatal death.

Looking at the care of 25 women and their babies, this report found that services did not meet the needs of these women effectively. Other key findings include:

• 96% of the women had a documented need for an interpreter, however, only 27% took place with a documented professional interpreter over 589 separate contacts with healthcare services.
• 68% of women didn’t book their pregnancy, or booked late in their pregnancy, highlighting gaps in antenatal care.
• Only 51% of women whose baby died received documented bereavement care in the community.
• There was a lack of research to inform service development for women new to the UK and non-English speakers.

Content

Recommendations

In addition to stating the continued relevance of previous recommendations, this report contains five new recommendations for improvement:

1. Ensure that the number of women who require language support, and the support provided at each visit, is recorded systematically. This includes documenting the use of professional interpreting services at clinical care interactions and when supporting women through the navigation of care pathways, as well as recording when these services are not available. The resulting data should be used to implement quality improvement measures, and be assessed against existing NICE guidance.
2. Ensure services provide advocacy for women who have been in the UK for less than a year, or do not speak or understand English, to support care navigation. This should incorporate midwifery and obstetric care when indicated.
3. 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 who have been in the UK for less than a year, or do not speak or understand English and require professional interpreting services. Use the findings to co-design services.
4. Pilot the provision of an initial assessment appointment for migrant women of childbearing age when they first access health care services. The purpose would be to carry out a holistic assessment of their reproductive healthcare needs, provide information about reproductive health and availability of maternity services, and to understand any concerns they may have about accessing healthcare services.
5. Develop provision for multiple routes of access to maternity care. These routes should include the ability for a health or social care professional, in any setting, to make a direct referral to maternity services on behalf of a woman with her consent.