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The UK government policy to charge overseas visitors and those without papers in the UK for national health services (NHS) is putting vulnerable migrants at risk, the Royal College of Midwives (RCM) has said.

The safety of mothers and babies is being put at risk by NHS fees that deter undocumented migrant women from accessing care, a new report from Maternity Action backed by the Royal College of Midwives (RCM) has stated.

NHS packages for overseas pregnant women start at £7,000 for antenatal, pregnancy and postnatal care, but can rise astronomically if the mother or child experience complications. Midwives said some women delay accessing help or fail to have scans over fears that they will be charged or detained. Some women were missing important tests and treatments or avoiding antenatal care altogether for fear of charges and Home Office sanctions.

The research found midwives were concerned the policy of charging for NHS care was undermining trust and generating a climate of fear.

Midwives interviewed for the report said they felt they were being used as ‘gatekeepers’ by the government.

“Midwives should not act as gatekeepers to maternity services,” said Gill Walton, chief executive and general secretary of the Royal College of Midwives.

Women who are chargeable for their maternity care include destitute women in the asylum system and women who have escaped sexual exploitation and domestic abuse, the report notes.

The study warned the charging particularly harms undocumented migrant women who already have a higher risk of maternal death and adverse pregnancy outcomes.

Maternity Action and the RCM asked the government to immediately suspend charging for NHS maternity care – and stated they want to stop debt from maternity care affecting future immigration applications.

One midwife said: “I am not here to enforce immigration rules, I am not here to enforce people’s entitlement, I have a duty of care as a midwife and I need to fulfil that duty of care.

“Part of my duty of care as a midwife is to gain the trust of people who are giving me medical history, who are entrusting me to guide them through the booking process which is the first step they are taking in pregnancy care. I need them to trust me and to trust the service.”

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