How can faith groups help reduce inequalities in pregnancy?
In December 2020, the UK was in the grip of another COVID-19 wave. There was the announcement that a new variant of the virus had been found in the UK, infections rates were climbing, and plenty of questions were being asked about the viability of plans for the holiday season.
Amidst the noise, two reports were quietly published on a different, though not unrelated, subject: the first, outlining data on babies who had died shortly before, during or after birth in 2018 (perinatal deaths); the second, looking at mothers who died during pregnancy between 2016-18, with recommendations to improve care. They were part of a series of annual publications known as the MBRRACE-UK reports, short for “Mothers and Babies: Reducing Risk through Audits and Confidential Enquires across the UK”.
Analysis of data from two years prior does not make for catchy headlines, especially in the middle of a pandemic. But what these reports tell us is significant. MBRRACE-UK findings are published yearly, and there is a lag in reporting, meaning the data does not describe the current state of things but builds a picture of trends over time. The most notable revelation in eight years of reports has been that, despite a welcome downward trajectory in perinatal deaths in the UK, there remain persistently worse outcomes for mothers and babies from black, Asian and mixed ethnic communities, as well as those living in deprived areas.
We must remember that deaths of mothers in pregnancy and childbirth are still extremely rare in this country. But the inequalities are stark: the latest figures show that, in the UK, stillbirth rates for black and black British babies in 2018 were over twice those for white babies, and that black mothers are four times more likely to die in childbirth than white mothers.
The COVID-19 lens
It has often been said that COVID-19 has not caused health inequalities but magnified them. The MBRRACE-UK reports underline this point, making clear the kinds of inequalities that have been entrenched for a long time, but which all too often go unrecorded, and unmentioned (there is still a paucity of data on the interaction between ethnicity and health). It is no surprise, then, that infections and deaths for COVID-19 have followed a similar pattern, and that 55% of pregnant women admitted to hospital with COVID-19 were from black and minority ethnic backgrounds.
But there is something else we can learn from the pandemic, and that is that when it comes to acting on inequalities communities are not powerless to make a difference. Our own research has long made the case for the role of faith-based organisations and community groups in public health and prevention. We know faith communities represent, or work with, populations who are marginalised and have high instances of certain diseases, and this makes them ideal places to run interventions and raise awareness. The huge efforts of faith communities up and down the country around the COVID-19 vaccine, both in disseminating messaging and hosting vaccination sessions, are an excellent example of this.
What if these strategies could be turned to other areas, like pregnancy and maternity? For example, data shows that black and minority ethnic women are less likely than white women to access care within 12 weeks of pregnancy, and timely access is a big factor in determining outcomes for mothers and babies. Greater awareness and appropriate messaging within faith and community centres, at this early stage, could make all the difference.
Get involved in a pilot initiative: How Can Faith Support Pregnancy?
As part of the VCSE Health and Wellbeing Alliance this year FaithAction are working with Wendy Olayiwola, National Maternity Lead for Equality at NHS England and NHS Improvement, to gather faith and community leaders together with NHS clinical leaders to share ideas and work towards better outcomes. We’re running this as a pilot initiative in East London, with the hope that some of the principles and lessons learned can form the basis for similar work further afield.
We have organised two meetings this month to kick off the work. Our first, held last night, gathered faith leaders, voluntary sector partners and representatives of local hospital trusts. It was a productive time of honest sharing, learning, and testing possible solutions.
We will be running another session next Wednesday (15th) at 6pm. If you’re interested in finding out more about this work, and contributing your voice, do sign up and join the discussion.
We’re aware this is only a beginning. We’ll take some time to digest what we’ve learned from these events and move forward with next steps into the new year. There will be plenty of opportunity to follow this work, and get involved, so keep an eye out for more developments.
The COVID-19 pandemic is far from over. But as we prepare once again to navigate the holiday season safely, let us remember two truths that have been thrown into sharp relief these past two years: the state of inequality in our nation, and the need to work in partnership with communities to provide solutions. Data on pregnancy and maternity is indicative of the wider picture of inequality that still beleaguers our nation. What’s our role to play in helping turn the tide?