NMC Ordered to Treat Racism as a Critical Maternity Safety Issue After Major England Review
The UK’s nursing regulator has been ordered to treat racism as a “critical maternity safety issue” following a major independent investigation into maternity and neonatal services across England that uncovered widespread inequalities, discrimination, and unsafe care.
The review, led by Baroness Amos, found that racism and structural discrimination are deeply embedded throughout maternity services and are directly affecting the safety and outcomes of mothers and babies.
The findings place significant pressure on the Nursing and Midwifery Council (NMC), which has now been given 12 months to begin urgent action to address racial bias within maternity care systems.
The report was based on one of the largest maternity reviews in recent years.
Baroness Amos heard evidence from more than 450 families, received over 10,500 public submissions, and gathered input from more than 9,000 healthcare staff through surveys, interviews, and trust visits. The investigation also included local reviews across 12 NHS trusts.
What emerged was a troubling picture of inconsistency, poor listening, workforce shortages, and widespread discrimination.
One of the most concerning findings was the disproportionate impact on Black women and ethnic minority families.
The review found that some women reported being left waiting significantly longer for care, having their pain ignored, or experiencing delayed recognition of deteriorating symptoms because of racial assumptions made by healthcare professionals.
In some cases, families said they felt they had to hide parts of their religious identity to avoid being treated differently.
Baroness Amos described racism in maternity care as not a “peripheral concern” but a serious patient safety issue that requires immediate national action.
The report highlighted how racial bias can affect everything from pain management to diagnostic decisions.
For example, it found that some clinical tools used to assess jaundice in newborns may not work effectively on darker skin tones, while some diagnostic thresholds for conditions like pre-eclampsia may miss higher-risk Black women at significantly greater rates than white patients.
The review also found inequalities affecting LGBTQ+ families and neurodivergent mothers.
Some parents said maternity forms and systems did not reflect different family structures, while neurodivergent women reported their specific needs were often overlooked during pregnancy and birth.
Staff were not spared from the findings either.
Many healthcare workers from ethnic minority backgrounds reported experiencing racism from both patients and colleagues, with some saying they felt afraid to report incidents due to fears of retaliation or being treated unfairly by management.
According to the Care Quality Commission data referenced in the report, more than one in five ethnic minority maternity staff reported experiencing discrimination from patients or the public over the past year.
The NMC has now been told to review referrals from trusts where inequality in access, safety, or outcomes is identified, specifically looking for signs of racial bias.
If concerns are found, the regulator must alert the relevant trust and ensure investigations take place.
The Department of Health and Social Care, NHS England, NHS Trusts, and the General Medical Council have also been named in the recommendations and told to work together to improve accountability and remove duplication.
NMC chief executive Paul Rees acknowledged the seriousness of the findings, saying the regulator must accept responsibility where it has “fallen down” and improve how it responds to maternity failings.
The report comes amid growing national concern over maternity safety in England, following several high-profile failings in recent years, including the Nottingham and Shrewsbury maternity scandals.
Campaigners say this latest review makes it clear that racism can no longer be treated as a separate diversity issue but must be seen as central to patient safety.
For nurses and midwives across the UK, the findings could lead to major changes in training, clinical practice, and accountability over the next year.
For families, especially those from ethnic minority communities, the hope is that the findings will finally lead to meaningful change in a system many say has failed them for too long.
