Maternity care in London a 'postcode lottery' during Covid-19 pandemic, report says

Londoners experienced a "postcode lottery" in maternity services during the Covid-19 pandemic, according to a new report. The London Assembly Health Committee found disparities in the levels of care provided between different NHS Trusts in the capital during Covid-19 restrictions.

In light of the report, the committee wants mayor Sadiq Khan to push for an NHS wide review to learn lessons from the Covid crisis, with the aim of determining how maternal health services in the capital should respond to future pandemics. Mr Khan said lessons needed to be learned.

The report looked at the impact of the pandemic on maternal health and services in London, the impact of staffing shortages, and the inequalities that exist across maternal health outcomes.

Covid restrictions during the pandemic meant some women lost their babies alone and partners banned from maternity wards. some respondends to the survey said they were left "traumatised" by their birthing experience.

Mia Roberts-Mukasa had her son, Oscar by emergency c-section in October 2021. At that time Covid restrictions in communities had been relaxed but in hospital - after her tiny son was rushed away to be incubated. - Ms Roberts-Mukasa was left alone for eight hours, lonely and scared.

It found inadequate staffing levels were a significant challenge, with retention of staff in particular a major obstacle.

Staff from minority ethnic backgrounds were more likely to face discrimination, be disciplined, and less likely to be promoted, the investigation found.

The pandemic was found to have a negative impact on the mental health of pregnant women and their partners; the most common reason for death for women in the 28-day postnatal period after giving birth is suicide.

A national survey run by Pregnant then Screwed, submitted to the Committe, found 90 per cent of pregnant women said that Covid restrictions had a negative impact on their mental health, with 97 per cent saying that the restrictions increased their anxiety around childbirth.

The report also found "huge disparities" in maternal health outcomes for people of different ethnicities.

Tinuke Awe, co-founder of Five X More, told the Committee that not all health professionals have a sufficient understanding of conditions that disproportionately affect women from ethnic minority groups, and that this can have an impact on the quality of care they provide.

Five X More’s Black Maternity Experiences Survey, which surveyed black women’s experiences of maternity services in the UK in 2022, found “clear evidence of inaccurate knowledge about the anatomy and physiology of Black and Black mixed women and how this impacted pregnancy.”

Dr Suzanne Tyler, executive director of Royal College of Midwives, told the Committee that when training maternity staff, ‘White’ is taken as the normal, though work is under way to correct this.

“If you have maternity staff who are not aware that Black women have four to five times higher risk, you cannot necessarily take the steps to ensure that they are having better care of safer care for that matter," Ms Awe said.

The Committee is also urging the Mayor to work with Mental Health First Aid England to explore creating a bespoke curriculum for the mental health of pregnant women and birthing people, new mothers, and parents.

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Chair of the London Assembly Health Committee, Krupesh Hirani AM, said: “We recognise that this was a challenging time for the NHS and restrictions were put in place to keep people safe, but our investigation shows that lessons need to be learnt from the pandemic about how to improve maternity care in London.

“Through our survey we heard about supportive and caring midwifery teams at London hospitals, but we were also told about difficult experiences while restrictions were in place – in some cases with long-lasting consequences on mental and physical health.

“The Mayor has a role to play in pushing for change in maternal health outcomes across our city and we urge him to take on our recommendations and advocate on behalf of those using these services in our city.”

Organisations including Pregnant Then Screwed, Birthrights, Five X More and the Royal College of Midwives all submitted evidence to the committee.