Faiza Abdi
Health Coordinator, Policy Connect
Reproductive health is fundamental to the wellbeing of women and girls. Yet, in the UK, women still face a stark gender health gap.
Women make up just over half of the population in the UK at 51%. There is a growing demand for fertility and reproductive services, highlighting inequalities that cannot be ignored.
Group experiences of reproductive health inequity
Significant and preventable inequalities affect some groups more than others. Black women, for example, are 50% less likely to be diagnosed with endometriosis than white women, despite experiencing it at similar rates, and face a higher risk of miscarriage.1 Maternal mortality in the UK is nearly four times higher for black women and almost twice as high for Asian women compared with white women.2
Women who are lesbian, bisexual or same-sex attracted (LBWSW) also face barriers, from lower cervical screening rates to higher teenage pregnancy rates, often driven by assumptions in sexual health, maternity and fertility services that don’t reflect their needs.
Disparities in meeting fertility care needs
These disparities are particularly visible in fertility care, where income, ethnicity, sexual orientation and geography can determine who gets access. With fertility rates at record lows and demand for services rising, addressing these gaps has never been more urgent.
For many people, the journey to parenthood is about more than biology. Ethnic minority and LGBTQ+ communities may encounter care that isn’t always culturally or religiously sensitive, with limited information and a lack of tailored support, adding extra stress to an already emotional experience. Success rates also vary: black patients aged 30–34 have an average birth rate of 23% after treatment, compared with 30% for white and mixed patients.
For many people, the journey to
parenthood is about more than biology
Access to reproductive health care
Access also often depends on where you live, as NHS-funded IVF varies across regions, with some areas offering fewer cycles or stricter eligibility, leaving couples facing long waits or high private costs. This postcode lottery highlights just how unequal fertility support can be.
Initiatives that aim to tackle women’s health inequity
Government initiatives such as the Women’s Health Strategy and the NHS Long Term Plan are starting to tackle some of these inequalities by investing in reproductive services to improve access, patient experience and reduce disparities. The Women’s Health Strategy, in particular, highlighted concerns around inconsistent implementation of fertility treatment guidelines and variations in funding across local areas.
Ensuring women have a choice
Women’s reproductive health and fertility care have been overlooked for far too long. They must be a priority, not an afterthought. By prioritising reproductive and fertility care, we can ensure everyone has the support and access they need to make informed choices about their reproductive futures.
[1] Nuffield Department of Women’s & Reproductive Health. 2023. Endometriosis: black women continue to receive poorer care for the condition.
[2] MBRRACE-UK. 2022. Saving lives, improving mothers care.
