Felicity Dowling
Maternity services in Britain are significantly damaged and damaging – damaging to mothers, babies, families and communities. The damage is also felt by workers and professionals: midwives, obstetricians and other NHS staff. On International Women’s Day 2026 and in the year that follows, let’s raise our voices long, loud and unceasing, to demand that maternity services are urgently repaired, restored and rebuilt for all our mothers, daughters, sisters, friends and lovers – and for every baby.
Maternal death rates in the UK have increased to levels not seen for almost 20years according to MBRRACE-UK Collaboration. “The maternal death rate for women from Black ethnic backgrounds has decreased slightly from the rate in 2019-21 but Black women remain three times more likely to die compared to White women. The maternal death rate for women from Asian ethnic backgrounds remains two times higher than that of White women; Women living in the most deprived areas still have a maternal death rate more than twice that of women living in the least deprived areas.”
Infant mortality has not improved. Black, Brown women – especially impoverished women, are much more likely to experience the pain and bereavement of infant deaths. Japan, Sweden, Denmark, Norway, Estonia, Slovenia and South Korea all have better infant mortality rates than the UK.
Caesarean sections have overtaken vaginal delivery. Only half of c-sections are planned in advance. Many mothers are choosing caesarean sections over vaginal deliveries. According to Soo Downe, a lecturer in midwifery, reporting to the BBC, “Many of those mothers chose it as the least worse option fearing that they might not get the support they need for a “safe straight forwards positive labour”. Induction of labour rates are also very high. The experience of giving birth must be improved and better supported as it is now overall worse than the 1980s. It is not enough for the government to blame women’s weight, age, social class or race.
Organisations of women, including organisations made up of and supporting Black women, are vocal about the damage. This damage hits the poorest women and babies hardest. The human rights charity for women and birthing people, Birthrights gave evidence to the Women and Equalities Committee in April 2023, advocating on its report, ‘Systemic Racism, Not Broken Bodies’, which detailed the devastating impact systemic racism has on the delivery of safe maternity care.
NHS staff deserve our thanks and our support as they too fight for improvements in the maternity service. The campaign, and petition – previously shared by SHA, to legally restrict the working day for midwives should be supported.
The damage to maternity services is well known to the government – well known to many who have used the service or had family using it. It is known to all who work in or around the service. It is documented and well reported. For a list of such reports please see here
However well reported and however much airtime these reports receive – these well documented dangers are not acted upon or prioritised in any effective way by the government. The overarching powers need to restrict spending by trusts and ICBs which has been valued above that of the lives and health of women and babies. Far from effective intervention, resources are inadequate and a major tranche of Maternity Safety improvement money was diverted last year to main ICB funding.
The government must recognise the need for major investment in maternity – no ifs no buts.
In an “enforcement undertaking” letter to Liverpool Women’s Hospital chiding them for not balancing the books, National Health England admitted that the maternity tariff, their major income stream, was “inadequate”. “3.2.1 the National Maternity Tariff does not meet the full cost of maternity services at the Licensee which include increased patient complexity and acuity which is driving changes in the case mix (for example, growth in deliveries by caesarean section in recent years) and interventions.”
Yet another report is being compiled by Valarie Amos. Many parents have welcomed this and it is ongoing. However, evidence of the problem was available before the Amos Report started. This evidence was comprehensive, including in multiple reports from parliament.
The Government knows about the ongoing damage; the damage is in plain sight. Their own documents describe it.
Damage is painfully obvious when the £27 billion cost of damages to patients from injuries at or giving birth out match the estimated £18billion total spend on maternity care since 2019.
The sources of these damages?
- Austerity: A driving force of this is inadequate funding. This inadequate funding drives cuts. Understaffing and overworked staff are core elements in this dangerous mix. Chronic underfunding must be addressed if any other interventions are to succeed.
- Poverty: An entirely avoidable and preventable variable that significantly affects women, especially mothers with young children and pregnant women. Austerity has badly hit women’s income, especially the income of women with children. The health of the baby is derived from the health of the mother.
- Allocation of resources: The Maternity Tariff and Birth Rate Plus, an invaluable tool, are both inadequate.
- Staff over work: Midwives are massively overworked, as described by SHA Maternity Working Group organiser, Pat Schan.
- Staff skill sets: There is a need for better management of deteriorating patients.
- Staff Training: University staff are concerned at the facilities and resources available for training midwives.
- Retaining staff: staff leave through stress and overwork meaning that the age and experience profile of midwives has significantly changed. “The rise in midwives leaving the profession is a warning sign we cannot ignore.” – RCM, 2025
- Racism: Racism in NHS maternity care worsens outcomes for Black women, Asian women and Muslim families. This contributes to billions in negligence claims. Black, Asian and minority ethnic (BAME) midwives and maternity support workers (MSWs) also experience bullying, harassment and discrimination at work, are “more likely to face disciplinary proceedings and have fewer opportunities to progress their careers.”– RCN, 2024.
- Uncosted policies: ‘Continuity of Care’ is undoubtedly a good service, and often indicated as a solution to the problems of the service. However, there are not sufficient midwives to provide this service and midwives often specialise in one aspect of maternity so are not available for full implementation of this method.
- Trauma and fear amongst women giving birth.
- Lack of respect for women giving birth
Demand resources, respect for women, demand proper consultation on methods to improve the outcomes and experience of giving birth.Make the government listen. Organise for maternity. Take the issue to the trade unions outside the NHS.