The Government must scrap punitive NHS charging of pregnant vulnerable migrant women, says the Royal College of Midwives (RCM). The College goes on to warn that the fear of having to pay for their care is stopping many women engaging with maternity services and puts the safety of their pregnancy at risk. 

The calls come as the RCM outlines its position on the care of vulnerable migrant women at an event at the Houses of Parliament today. It highlights the stark inequalities facing migrant women who are at higher risk of experiencing poor outcomes for themselves and their babies. Many of these women can also be in very difficult and dangerous social situations. This includes dependence on exploitative relationships for survival, destitution, homelessness, and involvement in criminal activity in which they may have little choice, if any. 

Clare Livingstone, Professional Policy Advisor at the RCM, and author of the guidance said: “A woman’s immigration status should never be a deciding factor on whether she can access pregnancy care, but for some women this is the case and that is shameful. The system puts barriers between them and our maternity services that can hinder them from using them, such as the fear of being charged when many cannot afford it. Because of this I have real fears that many of these women are not engaging with maternity services, are falling through the cracks, and are not getting the safe maternity care they need. This can have serious consequences on the safety and outcomes of their pregnancy for them and their baby.  

Women from Black and Asian backgrounds – which includes many migrants – are also significantly more likely to die in and around pregnancy compared to white women. This is a shocking indictment for a nation that prides itself on championing equality for all.” 

Another major concern is that women seeking asylum can be moved to unfamiliar areas often at very short notice. This can disrupt seriously their pregnancy care, rupturing trusting relationships they have developed with health professionals and in their community. It can also affect their antenatal care, such as causing problems with care continuity and access to important early scans and screening, with potentially serious consequences for the safety of the pregnancy. 

Currently migrant women should not be relocated from 34 weeks of pregnancy. The RCM is calling for this to be changed to 20 weeks. After that, pregnant migrant women should be settled into suitable accommodation in one place until after the birth and only when a GP or health visitor agrees mother and baby are fit to be moved, and any referrals for future care and support have been made. 

Clare Livingstone added, “Maternity care is deemed ‘urgent and immediately necessary’. This means all women in this country, regardless of their immigration status, are entitled to pregnancy care. No women should be afraid to come forward to get the care they are entitled to, and we must remove any obstacles that prevent them doing that. This means not charging them for their care. This message, and the support these women need must start on the UK’s doorstep with immigration and border services and run right through the doors into maternity units. This is fundamentally about providing safer care for these women and that must override any other considerations.” 

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