Report analyses data collected on cohort of 257 pregnant women with insecure immigration status
Doctors of the World (DOTW) last week released a brief new report examining the provision of maternity care for migrant women in the UK.
The 14-page report, "They don't count us as anything": Inequalities in maternity care experienced by migrant pregnant women and babies, can be read here.
The report is based on data collected on a cohort of 257 pregnant women with insecure immigration status who accessed DOTW UK's health support service between 2017 and 2021.
DOTW said: "For the first time we have information on time to first Antenatal Care (ANC) appointment, uptake of prenatal vitamins, outcomes after the delivery of the baby including week of delivery, delivery type, mental health of the mother and access to routine neonatal care and immunisations for the child. This important report adds to the limited data available highlighting the inequalities in access to maternity care experienced by migrant women."
The report finds that over 80% of the women in the cohort had their first antenatal care appointment beyond the recommended first 10 weeks of pregnancy. Nearly half of the migrant women did not have any antenatal care until after 16 weeks of pregnancy, compared with the national average of ten percent.
DOTW noted that over 60% of the women who did not receive antenatal care until after 16 weeks were from Sub-Saharan Africa. As women from Sub-Saharan Africa were only a quarter of DOTW's cohort, this highlights the ethnic and racial disparities in accessing healthcare.
Over a third of the women reported mental health issues. DOTW said this was potentially exacerbated by the costs many of the women incurred for their maternity care.
The report notes that NHS maternity care must never be withheld due to the inability to pay, but this caveat has done little to mitigate the impact that NHS charging regulations are having on pregnant migrant women. The cost of a normal delivery can be around £5,000 to £7,000, while complications, such as instrumental delivery or Caesarean Section, incur extra costs.
DOTW said: "Over a third of women (37.8%, 88 women out of the 233 with available data) reported receiving a bill for healthcare. Bills ranged from £296 to £14,000 with half (50%) of those receiving a bill being charged more than £7000."
The National Health Advisor for DOTW commented: "The NHS charging is something that affects migrant pregnant women a lot. Think about you have given birth to a child and they've given you a bill of £4000. I just went into depression stage. It got me really scared. I was even sometimes asking myself why did I even get pregnant in the first place to have this baby? It is devastating for a woman to be feeling that way and thinking that I put myself into trouble and I should have not gotten pregnant. Charging brought about so many things, what I could do with that child, what would happen with the bill. Charging migrant women is simply barbaric."
DOTW says the evidence in its report highlights how inequalities in access to antenatal care experienced by migrant women are likely to lead to poorer outcomes for their pregnancy and the health of their children.
DOTW added: "More broadly, the evidence in this report highlights the pressing need for independent action to be taken to review the impact of NHS charging policy as a whole on individuals and health inequalities with over a third of the women receiving a bill of their care. A growing body of evidence suggests that the NHS charging policy erodes migrant and Black and Minority Ethnic communities' trust in the NHS and undermines access to all health services."
The report makes a number of recommendations, including a call for the immediate suspension of NHS charging regulations for maternity care.