New NMC anti-racism principles will support universities to tackle Black maternal health crisis

Figures released by MBRRACE-UK show that Black women are three times more likely to die during pregnancy or in the immediate postnatal period, and maternal mortality rates for Asian women are 1.3 times as high compared with White women. The figures also show that Black babies are over twice as likely to be stillborn as white babies – with Asian babies 50% more likely to be stillborn.

Further reports from the Health and Social Care Committee, Five x More and Birthrights add to the growing evidence base that there are stark disparities in maternal outcomes.

The NMC’s initiative to launch anti-racism principles for midwifery education is supported by the Government and Royal College of Midwives (RCM), which is currently running a campaign – called Race Matters – which aims to ‘dismantle systematic racism within the midwifery profession’.

While each university designs its own curriculum, they have to be based on the NMC’s standards. This means that equity, diversity and inclusion (EDI) is already referenced in all midwifery education programmes, with many institutions already doing excellent work in this field.

However, there is much more that can be done to ensure consistency across all institutions delivering midwifery education.

In the spirit of continuous improvement, the NMC – which approves and monitors programmes throughout the UK – will work with all universities delivering midwifery education, to make anti-racism, bias awareness and cultural curiosity, safety and respect more explicit in their curricula.

The NMC will design the principles over the next few weeks and aims to publish them by late spring. It will then ask all universities to work to the principles from the start of the next academic year.

The NMC anti-racism principles will be co-designed with Black, Asian and minority ethnic people with lived experience of poor outcomes in maternity services.

The NMC says that a focus on these principles will help the next generation of midwives better ensure equitable outcomes for Black, Asian and minority ethnic women, babies and families.

The NMC is also aiming to produce anti-racism principles for nursing programmes along a similar timeline.

Paul Rees MBE, Chief Executive and Registrar, said:

“Every day, thousands of midwives deliver safe, kind and equitable care that brings joy to women and families across the UK.

“However, for far too many families, that has not been the case, with absolutely devastating consequences.

“The evidence is clear that racism within maternity services compounds the problem. Black and Asian women are more likely to die during pregnancy or in the immediate postnatal period, and their babies are more likely to be stillborn.

“The situation is totally unacceptable and is a national emergency.

“To help tackle the Black maternal health crisis we’re calling on our education partners to embed the new principles which will enable us to embed anti-racism, bias awareness and cultural curiosity, safety and respect across all midwifery education in the four countries of the UK.

“We hope that this initiative will make a real difference, meaning that Black, Asian and minority ethnic mothers, babies and families have a far better experience of maternity care across the four countries of the UK.”

Sharon Hodgson MP, Public Health Minister, Department for Health and Social Care, said:

"The stark disparities in outcomes for Black and Asian mothers and babies are unacceptable, and tackling them is a priority for this government.

"I welcome the NMC's commitment to embedding anti-racism principles across midwifery education, and I'm determined that we use every lever available to close these devastating gaps in maternal outcomes.

"We're taking urgent action to improve maternity services. This includes launching an anti-discrimination programme, hiring more midwives, and establishing a new Taskforce - chaired by the Secretary of State - to deliver rapid improvements in maternity and neonatal care, acting on the recommendations from Baroness Amos' independent investigation."

Gill Walton, Chief Executive, Royal College of Midwives (RCM), said:

"That Black, Asian and minority ethnic women continue to face such stark inequalities in maternity care is a disgrace and tackling this must be an urgent priority for the whole profession. The NMC's new anti-racism principles are a vital step in the right direction.

"This initiative builds on work the RCM has already been doing. In 2023 we launched our Decolonising Midwifery Education Toolkit – the first of its kind, co-created with educators, students and service users – to address the continuing legacy of colonialism within midwifery training. We subsequently developed our Decolonising Midwifery Practice position paper, setting out clear asks for government, NHS Trusts and Health Boards and individual practitioners.

"We are particularly pleased that the lived experience of Black, Asian and minority ethnic women will be central to the design of these principles and we look forward to working closely with the NMC to ensure they are as robust and effective as possible. No woman's outcomes should be determined by her race or ethnicity."

Professor Nicola Ranger, General Secretary and Chief Executive, Royal College of Nursing (RCN), said:

“By embedding anti-racism, unconscious bias awareness, and cultural competence training further into the learning of all midwives and nurses, we give our next generation of registrants the best chance of eradicating these unacceptable health inequalities once and for all. These new principles can be a vital step in bringing much-needed change in nursing and midwifery – whatever your race you always need to feel safe, cared for and listened to.”

Professor Habib Naqvi MBE, Chief Executive, NHS Race and Health Observatory, said:

“Racism in midwifery and nursing is a significant public health issue that undermines staff well-being and patient safety. That’s why it’s important that we address the structural barriers that place Black, Asian and minority ethnic women at increased risk is essential. This requires a clear commitment to challenge bias and discrimination wherever you find it, including within education. We therefore welcome the new principles designed to embed anti racism and cultural competence across midwifery and nursing education in the UK.”

Ed Hughes, Chief Executive, Council of Deans of Health, said:

“The Council of Deans of Health supports this work from the NMC which builds on the excellent work our member universities and colleges already do to combat racism in healthcare. It is clear that more needs to be done to address the racial disparities in maternal and newborn health outcomes. These new anti-racism principles will further assist our members in driving change, utilising education as a crucial tool to better deliver for Black, Asian and minority ethnic mothers, babies and families. We look forward to working with the NMC on the implementation of the new principles.”

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