Women’s equality in the UK – A health check

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12.56
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Case studies: 128
The innovative Enhanced Midwifery Service run by Liverpool Women’s Hospital offers
vulnerable mothers-to-be in deprived areas advice about health issues such as smoking
and diet in pregnancy and breastfeeding. Yet its future is in doubt after Liverpool City
Council said it would withdraw its 75% funding for the scheme and three maternity support
workers did not have their contracts renewed. The postnatal counselling group in Islington,
north London, for mothers with postnatal depression ended in March 2011 when funding
was withdrawn. Similarly, Andover birth centre in Hampshire is ‘temporarily suspended’, 129
Eastbourne maternity ward is being threatened with closure and the maternity unit at the
King George Hospital in Romford, Essex, is also under review.
Pregnant women, including refused asylum seekers, trafficked women, women whose
immigration status is dependent on their husband and undocumented migrants, are not
entitled to free NHS maternity care, putting not only their own health at risk but also that of
their unborn child. 130 (See Article 9) Migrant women who are charged for health care are not only
deterred from seeking help, but their needs are rendered invisible as women who are chargeable
are less likely to appear in data collected from health services. Charging regimes often lead to
increased costs overall. 131
Case study: 132
“One of the biggest problems we see relates to undocumented migrants who have given
birth, they are most often on their own and destitute, and once they return home with
their new born baby the hospital starts hounding them for tens of thousands of pounds
for medical bills. This is often the case with anaesthetist bills if she has had an epidural or
caesarean birth. Praxis was contacted by an undocumented woman who had given birth
to triplets and received a bill of over £200,000. The triplets were premature and needed
aftercare but this was an enormous sum for a woman with no legal income. She came to
Praxis very distraught and the NGO had to negotiate with the hospital until they eventually
agreed she could pay it back at £5 per week.”
The difficulties some women face in accessing maternity care also means that they lack
screening for HIV which would usually take place during their pregnancy. This may result in them
failing to access the treatment services for HIV that they need, and to prevent the mother to
child transmission of HIV. This has a profound impact on the potential for health of the unborn
child. The UK Government has failed to take steps for the provision of services that decrease
the infant mortality rate and prevent maternal mortality, by introducing practices that have
effectively denied pregnant women, including women with HIV, access to maternal healthcare. 133
(See Appendix: 24)
Despite overall increases in midwife numbers over the last ten years, the rising birth rate
128. Stephenson, M. (2011) TUC Women and the Cuts Toolkit: How to carry out a human rights and equality impact assessment of the spending
cuts on women. TUC: London http://www.tuc.org.uk/equality/tuc-20286-f0.cfm
129. Campbell, D. And McNicoll, A. (2011) ‘NHS cuts: the first casualties’, The Guardian, 11th April 2011 http://www.guardian.co.uk/society/2011/
apr/11/nhs-cuts-first-areas
130. The People’s Health Movement UK (2009) Shadow Submission on the Right to the Highest Attainable Standard of Health in the United
Kingdom for the International Committee on Economic, Social and Cultural Rights, 42nd Session, 4th – 22nd May 2009. In association with
Medact and Doctors for Human Rights http://www.phmovement.org/en/node/2002
131. Maternity Action (2012) Guidance for Commissioning Health Services for Vulnerable Migrant Women. WHEC: London http://www.
maternityaction.org.uk/sitebuildercontent/sitebuilderfiles/guidancecommissioninghealthservvulnmigrantwomen2012.pdf
132. From Bethan Lant of Praxis http://www.praxis.org.uk/ Accessed: 13/04/13
133. The People’s Health Movement UK (2009) Shadow Submission on the Right to the Highest Attainable Standard of Health in the United
Kingdom for the International Committee on Economic, Social and Cultural Rights, 42nd Session, 4th – 22nd May 2009. In association with
Medact and Doctors for Human Rights http://www.phmovement.org/en/node/2002
Women’s equality in the UK: CEDAW shadow report 2013 125