Welsh maternity team recognised for tackling inequalities in maternity care

on 03 May 2024

A maternity team in Wales have been recognised for their work in tackling inequalities and improving maternity care for pregnant women with learning disabilities and difficulty with everyday activities.

Having developed a Maternity Passport for the Hywel Dda Health Board to ensure the individual needs of the woman were understood and that reasonable adjustments were implemented, the team decided to widen their approach to tackling inequalities. Adding an additional question to the revised all Wales Maternity Handheld Record, they began asking all women what communication support they needed when using the maternity service. By asking all women inclusively, the team says it ensures that every woman using their maternity service has the opportunity to discuss reasonable adjustments to their care.

The Chief Nursing Officer (CNO) for Wales and the Royal College of Midwives Wales (RCM) Quality Improvement award for 2024 had many worthy nominees says the RCM, but it was this initiative from Hywel Dda that has been recognised as International Day of the Midwife (IDM) approaches.

Commenting, RCM’s Director for Wales, Julie Richards said:

“This year we’ve been really impressed with the range and quality of nominations which showcase our members’ commitment to improving the safety and quality of maternity services in Wales. The Maternity Passport was co-produced with women who use the service and those who need some adjustments and support with communication to ensure they got it absolutely right - and they did. The maternity team at Hywel Dda works in a positive culture, tackling improvements head on. They also take time to learn and train together considering inclusivity which is fundamental to improving multidisciplinary teamwork. All of this improves the quality of care they can deliver to women and their families using the service.”

The team at Hywel Dda has also hosted a series of training sessions entitled “Cuppa Conversation” to highlight challenges faced by marginalised women, the first series focused on the impact of race in maternity care and the current series is focusing on inclusivity and maternity care. These sessions are open to the multi-disciplinary team and are hosted both within and outside of usual working hours to support inclusion of all staff. The RCM says the sessions also promote an open and safe environment to discuss the impact of marginalisation on pregnancy outcomes enabling staff to learn from one another and share experiences.

Sue Tranka, Chief Nursing Officer for Wales, said:

“We want to ensure that equality, diversity and inclusion are at the heart of all our services in Wales. We expect everyone to be able to access high-quality maternity and neonatal care. Sadly, people with learning disabilities are at increased risk of poor outcomes, including pre-term birth and pre-eclampsia and they are also more likely to have poorer experiences of care. We are committed to delivering continued improvements across maternity and neonatal services in Wales and ensuring everyone can access equitable, high-quality care. We congratulate Hywel Dda on their multidisciplinary team working, engagement and co-production with families in developing this excellent tool.”

Karen Jewell, Chief Midwifery Officer for Wales added:

“It is wonderful to see Hywel Dda’s initiative included within the All-Wales Maternity Handheld Records and shared as best practice with other services across Wales. By asking the right questions, the tool ensures that all women have the opportunity to discuss their individual needs and any reasonable adjustments required to ensure they receive the care they need.”

Kathy Greaves, Head of Midwifery for Hywel Dda said:

“ I have immense pride in the teams dedication to addressing health inequalities for the women, birthing people and families of Hywel Dda. I would like to acknowledge the bravery of those affected by the inequalities who have supported the team. The impact is palpable and has spurred the team on to widen the scope of learning and clinical improvements in addressing a much broader understanding of Allostatic Load.  We are excited to progress the work and see what given the support and encouragement we can influence for other families using our services.”




For interview requests and to contact the RCM Media Office call 020 7312 3456, or email [email protected] 


  • *The team that has been awarded the CNO and RCM Wales Quality Improvement award for 2024 are:

Cerian Llewelyn, Lead Midwife for Risk and Governance

Faith Worrall, Clinical Supervisor for Midwives

Tipswalo Day, Obstetrician,

Sarah Burton, Specialist Public Health Midwife

Elizabeth Rees, Consultant Midwife

Rebecca Hall, Maternity Service User Experience Midwife


The Royal College of Midwives (RCM) is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team.  We provide workplace advice and support, professional and clinical guidance, and information, and learning opportunities with our broad range of events, conferences, and online resources. For more information visit the RCM | A professional organisation and trade union dedicated to serving the whole midwifery team