Perinatal health inequalities: bringing people together to make pregnancy and birth safer

Women and birthing people from a Black, Asian or mixed ethnic background are up to five times more likely to experience poor outcomes during their maternity journey, including a higher risk of maternal and neonatal death.

Bringing staff and service users together to discuss their issues and experiences is one way that services can be improved, such as through the use of "Whose Shoes" events.

Although the reasons why pregnant women who identify as being from an ethnic minority face poorer health outcomes are unclear, work is underway to understand and tackle these issues, including through the HEARD (Health Equity and Racial Disparity) in Maternity campaign in Croydon.

The Croydon HEARD team have already put together practical information - including a recommended care pathway - to help ensure that pregnant women have the best possible experience and feel listened to at every stage of their care.

Darzi fellow and midwife, Rosie Murphy, has been leading on perinatal inequalities in Croydon, particularly focusing on the accessibility of healthcare system to families who identify as being from an ethnic minority.

On April 4 2022, Rosie hosted an in-person “Whose Shoes” event - a thought-provoking, inclusive and highly interactive game encouraging partnership working and co-production across a diverse group of people. Just shy of 40 people attended (mixture of healthcare professionals, parents, voluntary sector, commissioners) with 19 evaluation forms returned. The themes that came up from the event were:

1. The right conversations came up during the game
2. Hearing things from other people's perspectives was viewed positively
3. Joining the NHS up with Voluntary Community and Social Enterprise stakeholders was viewed positively and the necessity of this appreciated/ understood.

Please visit the FAB NHS page to find out more.

The main outputs so far have been:

• Community - HEARD (Health Equity and Racial Disparity) campaign – membership expanded to include service user and vcse members (who attended on the day, plus future interested parties) as well as Health Visitor rep and early years public health members. Aim to co-design ongoing HEARD strategy and HEARD impact evaluation. The intention being that taking a collaborative approach will help to tackle this complex  problem
• Community/ Feedback – Annual Whose Shoes events & engagement lead (currently being recruited) to include engagement of Dads strategy
• Feedback – Health equity lens applied to monthly ‘temperature checks’ (survey of patient experience)
• Feedback - collaboration with health visiting to set up patient experience survey to be administered by health visitors so that women and birthing people/ their families can give feedback once they have had a chance for it to sink in (rather than when their baby is newborn or during the pregnancy)
• Communication – Translators on video link, portable to bedside
• Personalisation – work already underway due to Maternity Transformation Partnership, but focus on embedding culture of respect for women's autonomy and decision making
• Cultural competency – Recommendation to expand training to all maternity staff

This project is featured in our Annual Report 2022/23.

This project is featured in our Annual Report 2022/23.