“Gypsy and Traveller people are 20 times more likely to experience the loss of a child.”(Primary Care NHS Wales, 2025)

It’s the kind of statistic that should make us stop and take it in fully, because this is not a small disparity or a marginal difference that can be explained away by chance or individual circumstance. It points to something far deeper, something structural, relational, and embedded within the way care is offered, received, and experienced across maternity systems.

And it brings us to a question that is not always comfortable to sit with:

What is happening, within our systems and within our everyday interactions, that allows this gap to exist?

Beyond the numbers

Statistics can create a kind of distance, allowing something profoundly human to feel abstract or removed. But behind this number are families, mothers, and babies, and stories that are too often unheard, misunderstood, or reduced to data points.

For many Gypsy and Traveller communities, engagement with services is shaped by generations of mistrust, repeated experiences of discrimination, and a deep sense of not always being safe within institutional spaces. That context does not disappear when someone walks into an appointment. It is carried in with them, shaping how care is received, how communication is interpreted, and how safe it feels to engage at all.

Duty of care means everyone

In perinatal work, duty of care is something we all recognise as central to our role, but it extends far beyond clinical competence or adherence to guidelines. It asks us to consider not only what care is offered, but how that care is experienced by the woman in front of us.

Because when a woman does not feel seen, safe, understood, or able to engage fully, the care itself can struggle to land in a way that protects outcomes. And it is within that space that disparities begin to widen, often without being immediately visible.

Where gaps form

These gaps are rarely the result of one single moment or decision. Instead, they are shaped over time through interactions that do not quite connect in the way they need to.

A conversation that feels rushed, an assumption that goes unchecked, a moment where a woman does not feel able to ask a question, or a decision that is agreed to without being fully understood may seem small in isolation. Yet collectively, these experiences shape trust, and trust plays a significant role in whether care is accessed, followed, and experienced as safe.

This is not about blame

It would be easy to respond to a statistic like this with defensiveness or a sense of overwhelm, particularly for professionals who are already working within stretched systems and under significant pressure.

But this is not about individual fault. The intention to provide good care is already there.

What this asks of us is something different. It asks for awareness, for reflection, and for a willingness to look beyond what is being delivered on paper to how that care is actually experienced in practice.

Because intention alone is not enough to close gaps. It is the ability to see those gaps clearly that begins to shift them.

What this asks of us

This calls for a wider lens, one that moves beyond the idea that equal care means identical care, and instead recognises that equity requires responsiveness to difference.

It asks us to notice where standard approaches may not meet the needs of every community, and to consider the role that culture, history, communication, and trust play in shaping outcomes.

Most importantly, it asks us to take responsibility for how these factors show up in our own practice, not perfectly, but consciously and with a willingness to keep learning.

Sitting with the discomfort

There can be a strong pull in healthcare to move quickly towards solutions, to ask what needs to change or what should be done differently.

But there is value in pausing before that, and in allowing space for the discomfort of the question itself.

Why does this gap exist?What might I not be seeing?Where might my practice, however unintentionally, be part of a system that does not feel safe for everyone?

These are not easy questions to hold, but they are necessary ones if anything is to shift in a meaningful way.

If this has made you pause

If this statistic has stayed with you, or stirred something that feels difficult to name, that matters, because this is where change begins.

Not only in policy or large-scale reform, but in awareness, reflection, and the quieter shifts that take place within everyday interactions and decision-making.

There is a deeper layer to this work, one that looks closely at cultural humility, communication, trust, and how care is truly experienced by the families we support.

That is the focus of my Cultural Humility workshop for perinatal professionals, where there is space to explore these dynamics more fully and consider how care can shift in ways that genuinely build trust across communities.

Before you go

When you reflect on your own practice, where does care feel inclusive and effective across different communities, and where might there be gaps that have not yet been fully explored?