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Addressing Inequalities

Education

The core curriculum is divided into 14 Capabilities in practice (CiP’s). Each CiP outlines the key skills expected, along with a set of descriptors to help assess progress.

Within the curriculum specifically the following CiP’s address aspects of patient centred care

CiP 1 – the doctor is able to apply medical knowledge, clinical skills and professional values for the provision of high quality and safe patient-centred care. Facilitates discussions: modifies their approach to the patient when cultural background or personal values may have an impact on engagement and care. Ability to facilitate women’s decision making: shares information with patients and their families clearly, in a timely, non-judgmental fashion and facilitates communication (including use of a translator, advocate or supporter when needed)

CiP 13: The doctor is able to champion the healthcare needs of people from all groups within society: Promotes non- discriminatory practice: Recognises how health systems can discriminate against patients with protected characteristics and works to minimise this discrimination. Is able to perform consultations addressing the specific needs of a disabled person and being mindful that not all disabilities are visible. Understands the specific needs of transgender and non-binary individuals and is able to perform consultations and refer appropriately to specialist services

The Global Women’s Health e-learning module focuses on global neonatal and maternal health challenges and disparities. The module includes defining health equity and how it is measured in women’s reproductive health, multidisciplinary approaches to antenatal care provision for migrant women and the key barriers to accessing women’s healthcare for people recently arrived in the UK.

Guidance:

A Scientific Impact Paper (SIP) aims to inform those involved in the care of pregnant women in the UK about the relationship between social determinants of health and the risk of maternal death.

Advocacy

Addressing Inequalities

It is unacceptable that racial and ethnic inequities persist in obstetrics and gynaecology, in the careers and day-to-day working lives of O&G professionals, and in women’s health outcomes and experiences of care across their life course. The College is developing an ambition for race equality for future work that is sustainable and continues to contribute to the wider field of race equality in health and medicine.

The College have issued a statement on maternity care for women in prison in England and Wales. Women in prison should have access to high quality maternity care that is equitable to all other women living in the community, and the prison system must ensure that imprisonment does not compromise maternal or neonatal outcomes.

Existing policies and practices relating to the care of refugee, asylum seeking and undocumented migrant women particularly in England disrupt antenatal, intrapartum and postnatal care, prevent women from accessing services and ultimately influence maternal and perinatal outcomes. Access to timely, safe and appropriate maternity care should not depend on a woman’s immigration status or ability to pay. Addressing additional barriers to a safe pregnancy experienced by migrant women is a vital part of ending the UK’s persistent inequities in maternal and perinatal outcomes. A College position statement on access to maternity care for refugee, asylum seeking and undocumented migrant women. Following this publication the College continues to advocate. At our 2022 World Congress  joining with other organisations, the College highlighted the potential impacts of the Illegal Migration Bill on pregnant women. The College are also partners of the Migration And MAternal Health (MAMAH) Study identifying clinical and policy interventions to improve maternity care for underserved migrant women in the UK.

The College have worked with Fivexmore to develop 5 steps for healthcare professionals to help reduce inequalities in maternity care. This sets out five actions for healthcare professionals to adopt that will help drive change, change attitudes and put an end to these devastating inequalities.

Maternal Mental Health

Mental health is now recognised as a national priority by Government. In particular, we need more focus on the mental health journey and issues which face pregnant women and new mothers. The RCOG has launched the results of a survey of over 2300 women about their experiences of mental health problems during and after pregnancy.

Projects

The College has led on work exploring the multifaceted reasons for inequalities in maternity outcomes. The National Maternity and Perinatal Audit (NMPA) has undertaken research into ethnic and socioeconomic inequalities in maternity and perinatal care, and the COVID Maternity Equality Project (CMEP) aimed to learn how service innovation during the pandemic may have mitigated existing inequalities.