Now, more than ever, we must uphold human rights in maternity care

Over the decade, Birthrights has worked hard to ensure that everyone who is pregnant is treated with dignity and respect throughout their care. We do this by supporting women and birthing people directly through our advice service, delivering expert training on human rights in practice to healthcare professionals; and campaigning to improve services and practice throughout the maternity system through national inquiries, policy change and legal action.

Through this time we have seen there are Trusts and Health Boards who are fully committed to providing rights-respecting maternity care. There are midwives, consultants and registrars who are committed to person-centred care and are aware of the rights of women and birthing people to make informed decisions throughout antenatal, labour and postnatal care. We hear about healthcare professionals who made women and birthing people feel heard and respected in their decision about how and where to give birth, and decisions about what to accept for their own body. 

However, over the past ten years, we have also heard from thousands of women and birthing people and their families who have felt ignored, belittled or undermined in their pregnancy and childbirth decisions. Sadly, some have experienced more serious violations such as coercion or enduring procedures carried out without their consent or understanding. Worryingly, data throughout this period has consistently shown that those  most at risk of poor maternal outcomes are Black women and birthing people who are almost four times more likely to die in pregnancy and childbirth, while Brown and mixed ethnicity women and birthing people are twice as likely. Our year-long national inquiry into racial injustice in maternity care, which culminated in our report Systemic Racism, Not Broken Bodies, revealed the extent racism exists in UK maternity care. Black, Brown and mixed ethnicity women and birthing people described how they felt unsafe and their concerns were too often dismissed.

The increasing pressure on midwives, doctors and other healthcare professionals to deliver rights-respecting care against a backdrop of staffing shortages, lack of investment in services and poor leadership cultures, has contributed to unsafe maternity care. The failure to heed the findings from successive inquiries into maternity scandals such as Morecambe Bay, Shrewsbury & Telford, East Kent and Nottingham (which is currently underway) is deeply worrying.

We are proud of everything we have achieved as a small charity over the past ten years, but sadly there is still so much more work to do as we look forward as an organisation.

First and foremost, the voices of women and birthing people must be heard and their informed decisions respected. The failure to provide personalised and compassionate care is causing significant, long-lasting and avoidable harm to families, which has a wider impact on society as a whole. Women and birthing people, especially those at most risk of systemic racism, must be confident they will be offered safe maternity care that fully respects their right to bodily autonomy, self agency, and accepts their lived experience.

We are committed to working with healthcare professionals to raise awareness of and build confidence in delivering rights respecting care. Building an understanding of how the human rights framework applies to their role can empower staff to deliver the type of safe and personalised care that most joined the profession to uphold. But rights-respecting care cannot be delivered without proper, meaningful investment in maternity care. It is vital that government listens to the voices of those on the frontline who are demanding improvements to pay and conditions and the resources they need to deliver safe person-centred care.

There has never been more need for human rights to be recognised at the heart of maternity care. Birthrights will continue its mission to champion safe, personalised and equitable care and will continue to work with women and birthing people, healthcare professionals and the wider birthing community to realise this ambition.

Biography

Francesca is a senior communications and external affairs professional with a background in the music industry, most recently leading on communications, campaigns and government relations at the Independent Society of Musicians. Her experience of giving birth to her son in the first lockdown drove her to pursue a new life in the birth sector, first becoming Chair of her local MVP before joining Birthrights in 2021. She is passionate about ensuring all women and birthing people have access to safe, personalised and rights-based maternity care.