HSE to engage with groups to reduce maternal deaths among women of colour
The HSE said it is aware of the 'disproportionate over-representation' of ethnic minority women in adverse maternity events in Ireland.
The HSE is to hold engagements with representative groups to determine how to reduce the number of maternal deaths among ethnic minority women.
Of 13 maternal death inquests held between 2007 and 2021, six involved women of colour while all 13 inquests returned verdicts of medical misadventure, which has been labelled as a “major source of concern”.
The HSE said it is aware of the “disproportionate over-representation” of ethnic minority women in adverse maternity events in Ireland; however, it noted that Ireland’s data is similar to that of the US and the UK.
National Women and Infants Health Programme general manager Mary-Jo Biggs acknowledged that previous research showed “significant challenges” in communication, language and literacy skills, digital skills and access, timely access to care, and healthcare staff’s “unconscious bias and lack of cultural sensitivity”.
The HSE confirmed that it has written to the six maternity networks on two occasions, requesting that ethnicity be captured and considered as part of adverse event reviews.
In addition, it has started a project which will include interviews and focus groups and an examination of difficulties experienced by migrant women and ethnic minorities in accessing and using maternity services.
In a letter following a parliamentary question from Social Democrats leader Holly Cairns, Ms Biggs said: “The outputs of this project will enable the HSE to identify the barriers these women are encountering and provide a robust evidence-based approach to improving and enhancing access to services.”
Ms Cairns said the over-representation of ethnic minority women in maternal deaths is “a major source of concern”.
“All maternity-related deaths are tragic, and we need to work towards reducing this number. However, that women of ethnic minority backgrounds are disproportionately represented needs a particular focus and intervention,” said Ms Cairns.
She welcomed the actions taken by the HSE, particularly the direct engagement with migrant women and ethnic minorities on their experiences of maternity services; however, she said it must be a “proactive and candid process” that understands the barriers faced by ethnic minority women.
“This issue is also symptomatic of other problems concerning the understaffing and resourcing of maternity services. Hiqa reports have identified outdated physical infrastructure in maternity units and there are unfilled staffing posts.
“The National Maternity Strategy did not have a properly resourced implementation plan for many years. It took a Dáil motion calling for such a plan to push the Government into developing one,” she said.
Advocate and joint co-ordinator of campaign group The Elephant Collective, Jo Murphy-Lawless, said the HSE has “very belatedly” begun to take account of women of colour giving birth in Irish maternity services, saying the HSE response strikes the group as ‘fine words butter no parsnips’.
She said maternal death inquests have given a “microscopic account, step by step, of how women of colour have come to lose their lives in services which are badly structured and badly under-resourced, most especially given the needs of women marginalised by their ethnicity and their asylum status”.
“We want to give credit to the coronial system which is endeavouring through maternal death inquests to explore the circumstances of this disproportionate number of women of colour dying in our maternity services, and we would beg the HSE to be properly proactive in its responses about vulnerable women at the level of its hospital groups,” she said.
Dr Murphy-Lawless said 24% of women now giving birth were not born in Ireland.
“Many are women vulnerable on a score of needs which have been documented for two decades. When can we expect a focused policy response from the HSE and its constituent hospital groups?” she said.
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