Reproductive Borders and Bordering Reproduction: Access to Care for Women from Ethnic Minority and Migrant Groups

Recent research has reported a startling five-fold difference in maternal mortality rates among women from Black African/Caribbean ethnic backgrounds and almost two-fold difference among women from South Asian (particularly Pakistanis and Bangladeshis) ethnic backgrounds compared to White women. The COVID-19 pandemic has exacerbated these pre-existing inequalities with studies finding that over half of pregnant women with COVID-19 were hospitalised and seven of the eight pregnant women who died were from ethnic minority groups. These figures demonstrate that the current levels of reproductive and maternal health care inequalities constitute a serious public health crisis which requires a radical rethink of research and policy.

Structural frameworks around migration status further impact the accessibility and eligibility of free NHS care, intensifying the barriers to equitable healthcare for ethnic minority women. Those with ambiguous, uncertain, or insecure legal status are subject to immigration controls and are only able to access NHS services through health charging arrangements; accessing care with precarious status can even lead to detention and/or deportation. Not only does uncertainty about legal status deter migrant women from accessing care to which they are entitled, but ambiguous legal migration is often racialised, such that those from an ethnic minority background may be presumed to be ineligible for care without verification.

Evidence of these serious inequalities has already spurred on controversial policy initiatives pre-dating COVID-19, and issues related to such health disparities are increasingly at the forefront in policy agendas (e.g. the Royal College of Obstetricians and Gynaecologists - who is a key collaborator of this research proposal). Whilst policy attention is welcome, there has been an absence of sufficiently rich approaches that centralise women's experiences whilst contextualising these within the barriers associated with...