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Maternity Action, RCOG and RCM publish updated guidance on supporting access to maternity care for women affected by NHS charging

9 May 2024

Published today, the guidance supports NHS Trusts in England to implement NHS charging guidance with the minimum impact on pregnant women and people’s care, an important part of tackling persistent inequalities in maternity outcomes and experiences.

The RCOG has long called for an end to the UK Government policy of charging some pregnant women and people for maternity care, often those already at risk of poorer outcomes. The threat of charging is known to deter pregnant women and people from accessing essential and time-critical antenatal, intrapartum and postnatal care, and can leave women at increased vulnerability to domestic abuse and exploitative relationships.  

While these charging regulations do remain in place, NHS Trusts have an important role in minimising their impact. This can include ensuring care is never refused or delayed and supporting affected women to feel safe accessing care.

Shaped by obstetricians and midwives to ensure its relevance to day-to-day delivery of care, the guidance is designed to support NHS Trusts’ overseas visitor teams and finance departments to make changes to their policies and practices.

Professor Hassan Shehata, Vice President for Global Health at the Royal College of Obstetricians and Gynaecologists, said: 
“It is incredibly important that all pregnant women and people, regardless of their migration status, can access the antenatal, intrapartum and postnatal care needed to safely support their pregnancy. As such, we strongly urge all NHS Trusts in England to implement this guidance.

“Removing barriers to maternity care, including poor implementation of NHS charging regulations, will support faster progress towards the UK Government’s ambition to address ethnic and socioeconomic disparities in maternity care and halve the rates of stillbirths, neonatal and maternal deaths by 2025.”

More information

  • Read the full guidance here.
  • Read the RCOG’s policy position statement on equitable access to maternity care for migrant women here.
  • Read a blog from consultant obstetrician Dr Brenda Kelly on her experiences of the charging system and its impact on women here.
  • Watch our RCOG World Congress 2022 fringe event on access to maternity care here. 
  • Policy and governance
  • Pregnancy and birth