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Select committee: Health and Social Care Committee

Black Maternal Health

Open Opened 6 May 2025 9 recommendations 11 conclusions

Health and Social Care Committee Inquiry on parliament.uk ↗

Inquiry scope (the committee's words)
Black women in the UK are three times more likely to die in childbirth than White women, highlighting stark ethnic inequalities in maternal health outcomes. A 2022 Women and Equalities Committee inquiry identified systemic barriers, biases, and gaps in care. Several recent policies such as the Maternity Disparities Taskforce and the Women’s Health Strategy have aimed to address these issues, though little progress has been made to improve the variation in positive outcomes for Black women giving birth. This inquiry will assess barriers to progress, examine the effectiveness of current policies and strategies, and explore how local services and community-based care can reduce disparities and improve outcomes for Black mothers.

Where it stands

The inquiry is open, opened 6 May 2025.

The committee has published 1 report, most recently 3rd Report - Black Maternal Health on 17 September 2025.

The government's response

Published 16 December 2025. The deadline was 17 November 2025.

Summary written by Accountability Index from the government's response. It is not the government's own words.

The government welcomes the Committee's report and says it shares its view that disparities for Black women and babies are unacceptable, agreeing with several recommendations while pointing to existing programmes and an independent investigation.

  • On mandatory cultural competency training, the government recognises it as "a critical skill" but says the training "is not mandated"; trusts are "expected to cover the training" from the core competency framework topics.
  • The government agrees on diversifying NHS leadership, and says the Perinatal Equity and Anti-Discrimination Programme, which all trusts are "expected to complete by 2027", will support this.
  • On the investigation, the government says it "strongly agrees" that progress has been too slow, and that the final report and recommendations of the Baroness Amos investigation will be published in spring 2026.
  • On funding, the government says "Maternity funding has not been cut" and the ring-fence was removed to give local leaders more autonomy, so it does not restore the ring-fenced £95 million; it says it "will continue to monitor ICB investment".

Read the government's response ↗ Report an error

Recommendations and conclusions

All 20 recommendations and conclusions

Reports

All reports

Evidence

  • 2 oral evidence sessionsLatest 18 June 2025
  • 11 witnesses
All evidence

Recent activity

Recommendations and conclusions 20 shown

1: Optional cultural competency training for maternity staff is indefensible given outcome disparities.

Conclusion · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Concluded (the committee's words)
Safe maternity care for Black women is dependent on a workforce equipped to understand and respect their needs. Given the current disparities in maternity outcomes for Black women it is indefensible that cultural competency training is optional for NHS staff and leaders working in maternity services, and especially midwives. (Conclusion, Paragraph 26)

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2: Introduce mandatory, ongoing cultural competency training for all midwives, informed by co-production.

Recommendation · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We recommend the Department work with the NHS, the Royal College of Midwives, and the NMC to introduce mandatory, ongoing cultural competency training for all midwives, informed by co-production. A working group should review and update training materials to ensure they meet the needs of all ethnic groups. (Recommendation, Paragraph 27)

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3: Current system fails to incentivise NHS leaders to improve Black women's maternity outcomes.

Conclusion · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Concluded (the committee's words)
NHS leaders have a vital role in improving maternity outcomes for Black women and addressing the underlying culture and racism that underpin those outcomes. However, the current system does not incentivise leaders to focus on this issue or effectively hold to account Trusts that fail to make progress.(Conclusion, Paragraph 36)

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4: Set clear expectations for tackling racism in NHS leadership framework and performance agreements.

Conclusion · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Concluded (the committee's words)
The NHS leadership framework should set clear expectations for tackling racism and fostering an inclusive culture, reflected in chief executives’ performance agreements. It must also equip Ministers to hold Trust leaders accountable for creating anti-racist organisations and improving maternity outcome inequalities. (Recommendation, Paragraph 37)

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5: Lack of diverse representation in NHS leadership and midwifery education limits care.

Conclusion · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Concluded (the committee's words)
Addressing the current lack of diverse representation within NHS leadership and midwifery education is one practical action that can be taken to address concerns. When those entrusted with shaping clinical knowledge and practice and leading our healthcare organisations overwhelmingly reflect a single demographic, it limits the breadth of what is taught, prioritised, and thus, how care is delivered. (Conclusion, Paragraph 38)

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6: Include targets and strategies in the workforce plan to diversify NHS maternity leadership.

Recommendation · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Recommended (the committee's words)
The Government should also ensure the forthcoming workforce plan explicitly includes targets and strategies to diversify NHS leadership, specifically maternity service leaders and educators. This must be 32 accompanied with robust monitoring mechanisms that can be used to track progress and hold Trusts to account for their performance. (Recommendation, Paragraph 39)

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7: Progress on improving Black maternal health remains too slow despite multiple initiatives.

Conclusion · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Concluded (the committee's words)
While there have been multiple initiatives aimed at improving Black maternal health, progress remains too slow. We welcome the announcement of a rapid national investigation into maternity and neonatal care and the Secretary of State’s commitment to inequality being an integral part of its work. (Conclusion, Paragraph 43)

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8: National investigation into maternity care presents a turning point for equitable services.

Conclusion · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Concluded (the committee's words)
We hope that the national investigation will serve as a turning point for the country’s maternity services, and particularly the experience of Black women, by laying the foundation for a more transparent, accountable, and equitable maternity system. We will monitor the progress of the inquiry closely and intend to revisit its findings, with a view to undertaking further scrutiny at an appropriate stage. (Conclusion, Paragraph 44)

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9: Require the investigation to prioritise racial disparities and consider impact of funding cuts.

Recommendation · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We recommend that addressing racial disparities in maternal outcomes is one of the investigation’s core aims, and that this features prominently in the terms of reference for the second stage. We recommend that the investigation aligns with the priorities outlined by the Health Services Safety Investigations Body, specifically the defining of an accountability framework for maternity and neonatal services. Additionally, we recommend that the review carefully considers the impact of the significant reduction of ringfenced funding as outlined in this report. (Recommendation, Paragraph 45) Workforce

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10: Maternity workforce shortages remain a significant barrier to safe care provision.

Conclusion · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Concluded (the committee's words)
Workforce shortages remain a major barrier to safe maternity care, despite recent recruitment progress. We are disappointed the Government suspended its continuity of carer target, which is especially important for marginalised women, including Black women, who face greater challenges in being heard by the healthcare system. (Conclusion, Paragraph 62)

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11: Require Government to commit to safe maternity staffing and continuity of carer target.

Recommendation · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Recommended (the committee's words)
The Government must give firm commitments in the refreshed Long Term Workforce Plan to deliver safe staffing levels for maternity services. Without this, safe and sustainable maternity care will remain out of reach. As part of the workforce plan the Government must commit to rapidly reaching a level of staffing that will allow it to recommit to its continuity of carer target. (Recommendation, Paragraph 63)

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12: Suspension of RCOG safe staffing tool undermines maternity workforce stability.

Conclusion · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Concluded (the committee's words)
Suspending adoption of RCOG’s safe staffing tool has left Trusts without clear guidance on safe staffing levels, perpetuating poor workforce supply and undermining efforts to stabilise and support maternity teams. (Conclusion, Paragraph 64) 33

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13: Require the Department to update and publish the RCOG maternity staffing tool.

Recommendation · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We urge the Department to update and publish the tool produced by RCOG in time for the rollout of the upcoming refreshed Workforce Plan, so that every maternity unit can use it to plan effectively, ensure appropriate staffing and deliver consistent, safe care to all mothers and their babies. (Recommendation, Paragraph 65) Data

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14: Insufficient ethnicity data on maternal morbidity prevents monitoring and improving outcomes.

Conclusion · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Concluded (the committee's words)
Collecting robust, consistent, and equity-focused data on ethnicity and maternal morbidity is essential to enable health services to monitor and improve their services guiding improvements in maternal outcomes. Without it, it is significantly harder to produce accurate comparisons across all ethnic groups and evaluate disparities in maternal outcomes amongst different ethnicities, and gaps may obscure the true extent of disparities in outcomes for Black and other minority ethnic women. (Conclusion, Paragraph 79)

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16: Require the Ethnicity Recording Improvement Plan to include training and accountability for reporting.

Recommendation · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We recommend that this Plan should include details on staff training, support for data collection, and accountability measures to ensure Trusts meet their responsibilities. The Government must establish transparent mechanisms to monitor compliance and address failures in timely, accurate reporting, and outline these in its response to this report. (Recommendation, Paragraph 81)

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17: Accelerate development of the maternal morbidity indicator and provide a clear timetable.

Recommendation · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We are concerned that progress on developing a maternal morbidity indicator has been unacceptably slow, despite a Government commitment to do so over two years ago. We recommend the Department work with the National Institute for Health and Care Research to accelerate development and provide a clear timetable in response to this report. (Recommendation, Paragraph 82) Funding

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18: Reduced Maternity Service Development Fund risks widening disparities and compromising critical reforms.

Conclusion · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Concluded (the committee's words)
We are concerned by the Government’s decision to cut the Maternity Service Development Fund from £95 million to £2 million. While ICBs still have access to this funding, maternity services must now compete with other local priorities. While performance metrics in the 2025–26 NHS Assessment Framework aim to ensure accountability, they do not guarantee sufficient funding will be directed towards maternity services. Without sustained oversight and dedicated investment, maternity care risks losing momentum, 34 widening disparities, including in Black maternal care, and compromising critical reforms. We are also concerned about how the dissolution of NHS England and its absorption into the Department of Health and Social Care might impact the NHS’s ability to monitor maternity spending and maintain national oversight of progress. (Conclusion, Paragraph 90)

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19: Restore dedicated ring-fenced funding for maternity care Service Development Fund to £95 million.

Recommendation · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Recommended (the committee's words)
We strongly recommend that the Government restore the dedicated ring- fenced funding for the Service Development Fund for maternity care to £95 million. Properly targeted we believe this investment has the potential to reduce the substantial cost of maternity negligence claims to the NHS and more than pay for itself. (Recommendation, Paragraph 91)

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20: Set out how Government will monitor ICB investment and intervene in maternity services.

Recommendation · 3rd Report - Black Maternal Health · Addressed to Department of Health and Social Care

Recommended (the committee's words)
More broadly, the Government must ensure that maternity services continue to be a priority within ICB funding allocations. We ask the Government to set out in its response to this Report how it will monitor ICB investment in these services, including the impact of the removal of the ringfence if that decision is not reversed, and how it will intervene if it sees evidence that ICBs are underinvesting in maternity services. (Recommendation, Paragraph 92) 35

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Reports

1 report

Oral evidence sessions

2 sessions

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Date Session and witnesses Source
18 Jun 2025
Oral Evidence
Janet Fyle MBE · Royal College of Midwives, Kate Brintworth · NHS England, Professor Bola Owolabi · NHS England, Professor Hassan Shehata · Royal College of Obstetricians and Gynaecologists (RCOG), Professor Lucy Chappell · Department of Health and Social Care (DHSC), Sylvia Owusu-Nepaul · Birmingham and Solihull United Maternity & Newborn Partnership, The Baroness Merron · Department of Health and Social Care (DHSC) 		View ↗
14 May 2025
Oral Evidence
Professor Marian Knight · National Perinatal Epidemiology Unit, Shanthi Gunesekera · Birthrights UK, Sonah Paton · Black Mothers Matter, Tinuke Awe · Five x More 		View ↗

Who gave evidence

11 witnesses

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WitnessOrganisationSessions
Janet Fyle MBE · Professional Policy Advisor Royal College of Midwives 1
Kate Brintworth · Chief Midwifery Officer NHS England 1
Professor Bola Owolabi · Director of the National Healthcare Inequalities Improvement Programme NHS England 1
Professor Hassan Shehata · Senior and Global Health Vice President Royal College of Obstetricians and Gynaecologists (RCOG) 1
Professor Lucy Chappell · Chief Scientific Adviser Department of Health and Social Care (DHSC) 1
Professor Marian Knight · Director National Perinatal Epidemiology Unit 1
Shanthi Gunesekera · Co-CEO Birthrights UK 1
Sonah Paton · Co-Founder & Director Black Mothers Matter 1
Sylvia Owusu-Nepaul · Programme Director Birmingham and Solihull United Maternity & Newborn Partnership 1
The Baroness Merron · Parliamentary Under-Secretary of State for Patient Safety, Women's Health and Mental Health Department of Health and Social Care (DHSC) 1
Tinuke Awe · Co-founder Five x More 1

Correspondence

1 letter

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PublishedDirectionLetter
14 Jul 2025 Not recorded Correspondence from Baroness Merron re Black Maternal Health