Women’s equality in the UK – A health check

12.58
12.59
(particularly in inner-city areas), has meant maternity services do not respond to the needs
of all women. 134 For example, there are significant differentials in maternal health outcomes
for different ethnic groups 135 which highlight the importance of addressing racial inequalities
in the social determinants of health. There is evidence of much higher rates of infant
mortality in babies born to women who were born abroad and/or who belong to settled BMER
communities. 136 Studies reviewed for the NICE Guideline on birth outcomes 137 showed that
migrant women faced numerous barriers in accessing maternity services, of which language and
lack of information about the healthcare system were most significant. 138 A report in 2007 found
that women from BME groups have higher maternal mortality rates than other women: 5.6 times
higher for Black African women and 3.7 times higher for Black Caribbean women, for example,
and BME women had major problems in accessing maternity care. 139 There is evidence that this
has still not improved, for example, pregnant migrant women in Birmingham have to rely on food
banks to eat. 140
Women in disadvantaged areas in general do not receive the same quality in care, which
negatively impacts their (and their child’s) health. 141 Teenage mothers are also three times more
likely to suffer from postnatal depression and other mental health problems than older mothers
and are more likely to delay seeking maternity care by up to five months or more. 142
Recommendation:
Review policies on maternity care, in particular undertake a review of regulations,
guidelines and practice with the aim of ensuring access to maternity services
for all women
Women offenders
In 2008 the CEDAW Committee recommended to ensure adequate health, including mental
health, services for women in prisons 143 however we have seen little to address this since then.
Women in prison in general report high levels of sickness and poor health – in 2011 83% of
women in prison stated that they had long-standing illness compared with 32% of the general
female population and three quarters were on medication on arrival at prison. 144 For older
female prisoners there are also severe problems in regard to access to appropriate, adequate
healthcare and in-patient treatment whilst receiving healthcare – for example, shackling in
134. Healthcare Commission (2008) Towards better births: A review of maternity services in England. Commission for Healthcare Audit and
Inspection http://image.guardian.co.uk/sys-files/Society/documents/2008/07/10/Towards_better_births.pdf
135. Lewis, G. (2011) Saving Mother’s Lives: Reviewing maternal deaths to make motherhood safer 2006-2008. The eighth report on
confidential enquires into maternal deaths in the UK. The Confidential Enquiry into maternal and child health (CEMACH): London http://
www.cdph.ca.gov/data/statistics/Documents/MO-CAPAMR-CMACE-2006-08-BJOG-2011.pdf
136. Maternity Action (2012) Guidance for Commissioning Health Services for Vulnerable Migrant Women. WHEC: London http://www.
maternityaction.org.uk/sitebuildercontent/sitebuilderfiles/guidancecommissioninghealthservvulnmigrantwomen2012.pdf
137. National Institute for Health and Care Excellence, Intrapartum care (CG55) http://www.nice.org.uk/CG55 Accessed: 19/04/13
138. Maternity Action (2012) Guidance for Commissioning Health Services for Vulnerable Migrant Women. WHEC: London http://www.
maternityaction.org.uk/sitebuildercontent/sitebuilderfiles/guidancecommissioninghealthservvulnmigrantwomen2012.pdf
139. Confidential Enquiry into Maternal and Child Health (2007) Perinatal mortality 2005. CEMACH: London http://www.erpho.org.uk/
viewResource.aspx?id=16203
140. Lloyd, M. (2012) ‘Food crisis gripping Birmingham as pregnant women go days without a meal’, Birmingham Mail, 11th April 2012 http://www.
birminghammail.co.uk/news/local-news/food-crisis-gripping-birmingham-as-pregnant-182900
141. Department of Health (2009) Tackling Health Inequalities: 10 years on. A review of developments in tackling health inequalities in England
over the last ten years. DoH: London http://www.bris.ac.uk/poverty/downloads/keyofficialdocuments/Tackling%20HE%2010%20
years%20on.pdf
142. Platform 51 (2011) Health and wellbeing briefing. Platform 51: London http://www.platform51.org/downloads/resources/infosheets/
P51themesheet_healthwellbeing.pdf
143. CEDAW Committee (2008) Concluding observations of the Committee on the Elimination of Discrimination Against Women: United
Kingdom of Great Britain and Northern Ireland. Forty-first session http://daccess-dds-ny.un.org/doc/UNDOC/GEN/N09/555/92/PDF/
N0955592.pdf?OpenElement Para 20
144. Prison Reform Trust (2011) Bromley Briefing Prison Factfile, December 2011. PRT: London http://www.prisonreformtrust.org.uk/Portals/0/
Documents/Bromley%20Briefing%20December%202011.pdf
126 Women’s equality in the UK: CEDAW shadow report 2013