Professionals Helping vulnerable families Black and Minority Ethnic families Black and Minority Ethnic women and children have an increased risk of some poor outcomes: stillbirth and infant death – babies of mothers born in India, Bangladesh and East Africa have an increased risk, and mothers born in the Caribbean, the rest of Africa and Pakistan have double the risk compared with babies of mothers born in the UK (ONS data) low birthweight – babies of mothers born in the Caribbean, East Africa, India and Pakistan have an increased risk and mothers born in Bangladesh have double the risk compared with babies of mothers born in the UK (ONS data) preterm birth – babies of mothers of Afro-Caribbean and African origin are at increased risk compared to babies of mothers of other ethnic origins (Aveyard et al, Macfarlane et al) congenital abnormalities – babies of mothers of born in India and Bangladesh are at increased risk and babies of mothers born in Pakistan are three times more likely than babies of mothers born in the UK to be born with a congenital abnormality (Blarajan et al) severe maternal morbidity – Black and Minority Ethnic women are 50% more likely than White women to suffer severe maternal morbidity, and the risk is more than double for women of African and Afro-Caribbean origin (Knight et al) maternal death – mothers of Black Caribbean and Black African origin are more than three times more likely to die in pregnancy or in the year after birth than White women. (Saving Mothers’ Lives) late booking for antenatal care - women of South Asian origin are likely to initiate care later and have fewer antenatal visits than White women; women from some Black and minority ethnic groups are more likely than White women to book for maternity care later than 22 weeks of pregnancy, to miss more than four antenatal visits or to receive no antenatal care at all; women who are asylum seekers or refugees are disproportionately represented within unbooked births (Rowe & Garcia; Saving Mothers’ Lives) Improving care – information and resources Barriers to care for BME women http://www.training.medact.org/training/module/17/ Muslim parents Ali N & Burchett H. Experiences of maternity services: Muslim women’s perspectives. Maternity Alliance 2004http://www.maternityaction.org.uk/sitebuildercontent/sitebuilderfiles/muslimwomensexperiencesofmaternityservices.pdf Gypsy Travellers Key points on a report into gypsy traveller maternity experienceshttp://www.gypsy-traveller.org/your-family/health/baby/ Gypsy and Traveller culture: http://www.plymouth.gov.uk/gypsy_and_traveller_culture.pdf Nock M The Experience of Maternal Health services by the Bromley Gypsy Traveller Community http://www.bromley.nhs.uk/getting-involved/equality/equality-impact-assessments/?assetesctl5112=1286 Van Cleemput P et al. Health of Gypsies and Travellers in England: Qualitative Report. Oct 2004 http://www.sheffield.ac.uk/polopoly_fs/1.43712!/file/GT-qualitative-report.pdf Asylum seekers and refugees McLeish J. Mothers in exile. Maternity experiences of asylum seekers in the UK. Maternity Alliance 2005http://www.maternityaction.org.uk/sitebuildercontent/sitebuilderfiles/prisonsreport.pdf Dunkley-Bent J Healthcare provision for pregnant asylum seekers and refugeeshttp://www.radcliffe-oxford.com/books/samplechapter/6932/Momoh_06-29f35200rdz.pdf Mcleish J, Cutler S, Stancer C. A crying shame. Pregnant asylum seekers and their babies in detention. www.biduk.org/download.php?id=18 Nabb J. (2006) Pregnant asylum-seekers: perceptions of maternity service provision. Evidence Based Midwifery 4(3): 89-95 www.rcm.org.uk/EasysiteWeb/getresource.axd?AssetID...servicetype.. http://www.refugeecouncil.org.uk/ Female genital mutilation Royal College of Nursing. Female genital mutilation. An RCN educational resource for nursing and midwifery staff.http://www.rcn.org.uk/__data/assets/pdf_file/0012/78699/003037.pdf FORWARD http://www.forwarduk.org.uk Access to free NHS care for women from overseas http://www.maternityaction.org.uk/entitlementhealthcare.html Culture and maternity – understanding other cultures’ maternity practices http://www.training.medact.org/training/module/18/ Guide to working with interpreters http://www.training.medact.org/training/module/19/ Migration and maternal mental health http://www.training.medact.org/training/module/21 Free online training on working with marginalised women from black and minority ethnic communities, including asylum seekers and new migrants: ‘Breaking down the barriers’ training http://www.training.medact.org/training/package/6/ Other language resources Eating while you are pregnant - Food Standards AgencyAvailable in Bengali, Chinese, Greek, Gujurati, Hindi, Punjabi, Turkish, Urdu http://www.food.gov.uk/aboutus/publications/pubsminority/ Eating for breastfeeding - Food Standards Agency Available in Bengali, Chinese, Greek, Gujurati, Hindi, Punjabi, Turkish, Urduhttp://www.food.gov.uk/aboutus/publications/pubsminority/ Feeding Your New Baby: Important information for mothers to be Available in Arabic, Bengali, Chinese, French, Gujarati, Hindi, Lithuanian, Mirpuri, Polish, Portuguese, Punjabi, Somali, Spanish, Tamil, Turkish, Urdu, Vietnamese and Welsh. BreastfeedingAvailable in Arabic, Bengali, Chinese, Farsi, French, Gujarati, Kurdish, Punjabi, Somali, Turkish, Urdu.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4084370 Breastfeeding Your Baby Available in Arabic, Bengali, Gujarati, Hindi, Mirpuri, Polish, Punjabi, Spanish, Tamil, Turkish and Urdu. Bottle FeedingAvailable in Arabic, Farsi, French, Kurdish, Somali and Turkish Sterilising baby feeding equipment Available in Albanian, Bengali, Chinese, French, Hindi, Punjabi and Urdu. Fun first foods: An easy guide to introducing solid foods Health ScotlandAvailable in Mandarin, Polish, Turkish and Urdu.Newborn blood spot screening Available in Arabic, Bengali, French, Greek, Gujarati, Portuguese, Romanian, Somali, Turkish, and Urdu. http://www.newbornbloodspot.screening.nhs.uk/resources/delivery.htm#parents Sharing a bed with your babyAvailable in French, Japanese, Portuguese, and Spanish. http://www.babyfriendly.org.uk/items/resource_detail.asp?item=328&nodeid= Reduce the Risk of Cot Death: An Easy Guide Available in Arabic, Bengali, Cantonese, Gaelic, Hindi, Polish, Punjabi, and Urdu. Talk To Your BabyAvailable in Arabic, Bengali, Chinese, French, Gujarati, Polish, Portuguese, Punjabi, Tamil, Turkish, Urdu and Welsh. A guide to immunisation for babies up to 13 months of age Available in Arabic, Bengali, Cantonese, Czech, Farsi, French, Greek, Gujarati, Italian, Kurdish, Pashto, Polish, Spanish, Somali, Tamil, Turkish, Urdu, Vietnamese. http://www.immunisation.nhs.uk/Library/Publications/Translations Miscarriage AssociationMany leaflets available online including some translated in Arabic, Bengali, Gujarati, Punjabi, Turkish and Urdu and audio tape in English, Urdu, Mirpuri and Bengali (Sylheti). http://www.polishinformationplus.co.uk/index.aspx Information in Polish about services in Scotland, including antenatal care and immunisations. References Aveyard P, Cheng K, Manaseki S, Gardosi J. The risk of preterm delivery in women of different ethnic groups. British Journal of Obstetrics and Gynaecology 2002; 109:894-899. Blarajan R, Soni Raleigh V, Botting B. Mortality from congenital malformations in England and Wales: variations by mother’s country of birth. Archives of Disease in Childhood 1987;62(7):709-711. Knight M, Kurinczuk JJ, Spark P, Brocklehurst P. Inequalities in maternal health: national cohort study of ethnic variation in severe maternal morbidity. BMJ 2009;338:b542. MacFarlane A, Grant J, Hancock J, Hilder L, Lyne M. Early life mortality in East London: a feasibility study. Summary report. Fetal and Infant Death in East London. City University, 2005.) Rowe R & Garcia J. Social class, ethnicity and attendance for antenatal care: a systematic review. Journal of Public Health Medicine 25:113-119 (2003).