New Research Uncovers Ethnic and Socioeconomic Inequalities in Stillbirth Rates Across English Healthcare Facilities

Recent research led by the University of Bristol has uncovered significant ethnic and socioeconomic disparities in stillbirth rates within hospitals and healthcare trusts across England. The study, published in BJOG: An International Journal of Obstetrics & Gynaecology, reveals that Black and Asian women experience higher stillbirth rates compared to their white counterparts, with those living in the most deprived areas facing the greatest risk.

Analyzing data from 1.3 million births across 130 NHS Trusts in England, this study is the first to document these disparities at the hospital and trust levels. Current statistics indicate an overall stillbirth rate in the UK of 3.4 per 1,000 births. Previous research had not provided sufficient evidence regarding how maternal ethnicity and socioeconomic status influenced stillbirth rates at the local healthcare level.

The analysis utilized data from the National Maternity and Perinatal Audit, focusing on births recorded between 2015 and 2017. Findings indicated that stillbirth rates differed not only between hospitals but also within individual trusts, based on the ethnicity of the mothers. Specifically, the stillbirth rate among Black women was found to be double that of white women, with rates at 7.1 per 1,000 births for Black mothers compared to 3.4 per 1,000 for white mothers. Furthermore, the study found that stillbirth rates were significantly influenced by socioeconomic factors, with rates of 2.9 per 1,000 births in the least deprived areas contrasted with 4.7 per 1,000 in the most deprived areas, reflecting a relative increase of 62%.

Researchers highlighted that the variation in stillbirth rates across different NHS Trusts can largely be attributed to socioeconomic and ethnic inequalities. Notably, some trusts reported below-average stillbirth rates for white women while concurrently exhibiting above-average rates for Black and Asian women, indicating that systemic issues within healthcare delivery may contribute to these disparities.

In response to the findings, leaders from Tommy's National Center for Maternity Improvement emphasized the urgent need for systemic changes to address these inequalities in maternity care, advocating for equitable care for all women, irrespective of their ethnic or socioeconomic background. They pointed out that behind each statistic lies a family profoundly affected by the loss of a child, underscoring the need for improved healthcare access during pregnancy.

Maria Viner, CEO of Mothers for Mothers, a mental health charity supporting mothers facing challenges during and post-pregnancy, noted that the impact of stillbirth extends beyond immediate grief, affecting family dynamics and mental health long-term. The study's authors recommend further analysis using recent data to monitor changes in stillbirth rates across NHS Trusts and to evaluate the effectiveness of interventions aimed at reducing these disparities.

The findings align with the MBRRACE-UK perinatal mortality surveillance report, which emphasizes the need for comprehensive strategies targeting both socioeconomic factors and ethnicity to effectively reduce stillbirths. Researchers advocate for early pregnancy risk assessments that incorporate both ethnicity and socioeconomic status to facilitate targeted interventions.