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Background

Analysis of maternal deaths, stillbirths and neonatal deaths shows mothers and babies from Black/Black British and Asian/Asian British ethnic groups and women living in the most deprived areas of the country have poorer outcomes.[1]

The table below shows data from the latest 2020 MBRRACE-UK report on the Confidential Enquiry into Maternal Deaths 2016-18 highlighting the number of maternities and associated deaths by ethnicity. The data is pooled over a three-year period because the small number of cases means that the estimated rates can be associated with a large degree of uncertainty. The associated relative risk of death for women from ethnic groups compared with white women is also provided, along with the confidence intervals associated with these ratios.[2]

The confidence intervals shown below suggest that women from Asian, Black or mixed race backgrounds have an elevated risk of maternal death compared to women from White backgrounds.  Among Black women, the central estimate of the risk of maternal death is more than four times higher than for white women.

 Confidential Enquiry into Maternal Deaths 2016-18, Table 2.10

Source: Confidential Enquiry into Maternal Deaths 2016-18, Table 2.10

Further details of MBBACE-UK’s work is available on its website.

In a response to a PQ in 2019, the Secretary of State for Health and Social Care was asked why maternal mortality rates are higher among BAME women:

PQ [on maternal mortality: ethnic groups] 245969

Anneliese Dodds (Oxford East):

To ask the Secretary of State for Health and Social Care, for what reason maternal mortality rates are higher among BAME women.

Jackie Doyle-Price, Department of Health and Social Care:

The higher rates of maternal mortality experienced by black, Asian and minority ethnic (BAME) women is a complex and serious issue. The Department has commissioned the Policy Research Unit in Maternal and Neonatal Health and Care at Oxford University to undertake a research project in 2019-20 to investigate the factors associated with excess perinatal and maternal mortality. The Department will use findings from research to inform future maternity policies.

Current plans to reduce inequalities are set out in the NHS Long Term Plan, we aim to tackle maternal mortality inequality through the introduction of an enhanced continuity of carer model. By 2024, 75% of women from BAME communities and other vulnerable women will receive continuity of care from their midwife. This will also help reduce pre-term births, hospital admissions, and the need for intervention during labour.

[Answered on: 25 April 2019]

[1] MBRRACE-UK, Saving Lives, Improving Mothers’ Care, December 2020

[2] The uncertainty of a ratio can be estimated by calculating a confidence interval (CI) around the estimate to give an indication of the range within which the “true” ratio is likely to arise. The confidence intervals are important in interpreting differences. A confidence interval expresses the degree of uncertainty associated with a statistic and gives an indication that that actual “true” value may lie somewhere between the lower and upper confidence interval. You can use the overlap in confidence intervals as a quick way to check for statistical significance. In general, if the intervals do not overlap there is a statistically significant difference (at a certain level of confidence – usually 95%) whereas if there is an overlap, then the difference is not significant.


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