Babies of Black Mothers Face 81% Higher Neonatal Mortality Risk in England and Wales, New Study Reveals

Stark Disparities in Neonatal Care Outcomes Identified

A recent study led by academics at the University of Liverpool has revealed a significant disparity in neonatal mortality rates across England and Wales. The comprehensive analysis, published in The Lancet Child & Adolescent Health, found that babies born to Black mothers are 81% more likely to die while in neonatal care compared to those born to white mothers. This elevated risk persists even after accounting for factors such as deprivation and maternal or birth-related conditions.

The research, funded by the National Institute for Health and Care Research (NIHR), examined data from over 700,000 babies admitted to NHS neonatal units across England and Wales between 2012 and 2022. It highlighted that the highest mortality rate for Black babies stood at 29.7 deaths per 1,000 babies, in contrast to 16.9 deaths per 1,000 babies for white infants. Furthermore, babies born to Asian mothers also faced a 36% higher risk of death than their white counterparts. The study's lead author, Samira Saberian, a PhD student at the University of Liverpool, emphasized that 'socioeconomic and ethnic inequalities independently shape survival in neonatal units'.

Intersectional Inequalities and Broader Context

Beyond ethnicity, the study also underscored the profound impact of socioeconomic factors. Babies born to mothers residing in the most deprived areas of England and Wales were found to be 63% more likely to die in neonatal care compared to those from the least deprived areas. In 2022, the highest mortality rate for babies from the most deprived backgrounds was 25.9 deaths per 1,000 babies, significantly higher than the 12.8 deaths per 1,000 for those from the least deprived areas.

These findings align with previous reports from MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK), which have consistently highlighted higher rates of stillbirth and neonatal death among Black and Asian populations. MBRRACE-UK confidential enquiries have identified issues such as poor care quality, the absence of interpreters, and clinical management problems, including delays in resuscitation, thermal care, and sepsis treatment. Disparities in care delivery extend to lower rates of deferred cord clamping, early breastmilk feeding, and parental involvement in ward rounds for minority ethnic groups.

Calls for Urgent Action and Policy Responses

The findings have prompted strong reactions from healthcare professionals and organisations. Rachel Drain, quality and standards adviser at the Royal College of Midwives, described the figures as 'deeply concerning' and called for 'urgent, coordinated action' to address the root causes of these disparities. The head of the Royal College of Midwives has previously attributed such disparities to 'institutional racism'.

In response to these persistent inequalities, NHS England is actively working to improve equity and equality in maternity and neonatal care. Initiatives include the Core20PLUS5 approach and guidance for Local Maternity Systems to develop Equity and Equality Action Plans. The NHS Race and Health Observatory has also published a review detailing challenges and recommendations for Black, Asian, and minority ethnic babies in neonatal care, pointing out limitations in current assessment tools like the Apgar score. Organisations such as Black Mothers Matter are also working to enhance the safety and quality of care for Black mothers and their babies, advocating for systemic change within the NHS.