Motherhood
Call for urgent global action on women’s health research
Women’s health is being neglected by researchers, prompting calls for urgent action to address major gaps in care across both high- and low-income countries.
Dr Anita Zaidi, president of the Gates Foundation’s gender equality division, said a lack of research is holding back progress in tackling common but often overlooked conditions.
She pointed to innovations ranging from smartphone ultrasound devices to low-cost tools that reduce deaths from post-birth bleeding.
Dr Zaidi said: “From an R&D perspective, it’s been one of the most neglected areas in global health. It’s neglected not just in global health but also in rich countries,”
“Women’s health has just been ignored.”
Giving birth can carry high risks, she added, and maternal health remains under-researched.
The Gates Foundation has identified major research gaps, including in endometriosis, malnutrition and pre-eclampsia.
She highlighted Kenya’s KENSHE study, which led Ireland to adopt a one-dose HPV vaccine schedule – down from the previous three doses – showing how findings in lower-income countries can influence global health policy.
Dr Zaidi urged governments not to cut funding for research, as the US and UK scale back investment.
“We have made so many advances in women’s health, especially in R&D, so now not to have the funding available to scale them really bothers me,” she said.
One project funded by the foundation, involving 200,000 women, found that guidelines for post-partum haemorrhage – a major cause of maternal death – need revision.
Current protocols, including in Ireland, define blood loss of 500ml in 24 hours as mild, but the study suggests care should begin at 300ml.
Dr Zaidi said: “You put it under the mum, with a calibrated sleeve at the end of it so all the blood is captured in there.
“And once they used that sheet and a bundled approach it was so impactful. There was a 60 per cent decrease in severe post-partum haemorrhage.
“The other thing that they realised is the 500ml cut-off is too high, it should be 300ml.
“So now we know we should be treating post-partum haemorrhage when there’s more than 300ml blood loss and we have to act quickly.
“If you could do that, you will save hundreds of thousands of women’s lives.”
Other innovations include AI-powered ultrasound probes that attach to smartphones and cost around 20 times less than conventional machines, allowing midwives in remote areas to assess patients and prioritise care.
She said: “In Sudan, let’s say, where one midwife may be taking care of 100 women, this helps you triage who really needs help the most.”
The device has been described as “a game-changer”, though broader funding is still needed.
She also referenced the Irish Examiner’s recent women’s health survey, which highlighted further gaps in research and care.
The foundation is committing €316m each year from 2023 to 2027 to maternal, newborn and child health.
Bill Gates has pledged to give away 99 per cent of his wealth over two decades, with the foundation set to close in 2045.
Dr Zaidi said: “It’s enough time if we plan for it in the right way, and this is why we wanted to give enough notice.
“For the many of the innovations I’ve been talking about, they can be done in the next 10 to 15 years, but some will need a hand-off.”
The Royal College of Midwives (RCM) has referred to the women’s health strategy as a ‘missed opportunity’ to address maternity services.
The renewed strategy was released by the government this week, with the aim of putting women’s experiences at the centre of care and ensuring they are “better heard and served”.
However, the government stated that because of ongoing investigations into maternity services across the country, the strategy “does not seek to address safety in maternity and neonatal services”.
The RCM described this as a “missed opportunity” and urged the government to ensure that, following the inquiries, maternity is placed “at the very heart” of the strategy.
Gill Walton, RCM chief executive, said the college was “deeply disappointed” that maternity services “do not feature as a headline priority” in the renewed strategy.
She said: “This is a significant missed opportunity and one that is very difficult to understand.
“Pregnancy, birth and the postnatal period are not a footnote in women’s health – they are one of the most significant and consequential phases of a woman’s life.
“A strategy that treats maternity as an afterthought is not truly a women’s health strategy at all. It is exactly the kind of thinking that has allowed maternity services to reach the point they are at today.”
Walton acknowledged that the strategy contained commitments on ensuring women’s voices shape their care, on supporting families through pregnancy loss and on the principle that services should be held accountable when they fail to listen to women.
She added: “But a strategy that addresses one part of women’s health while leaving maternity care behind is only doing half the job.”
Walton urged the government to ensure that this is addressed when the ongoing investigations into maternity care conclude, with any recommendations placed “at the very heart of this strategy with the seriousness and urgency that women, families and midwives deserve”.
In the foreword to the renewed plans, health and social care secretary Wes Streeting referred to the ongoing independent National Maternity and Neonatal Investigation as action being taken by the government to improve safety in maternity services.
The strategy also refers to the new National Maternity and Neonatal Taskforce, chaired by Streeting, which aims to help deliver “safer, more equitable care” for women, babies and families.
The foreword said that, because of ongoing initiatives, it was “important that this work continues without restriction and that the government can properly respond to the findings”.
It added: “This renewed women’s health strategy therefore does not seek to address safety in maternity and neonatal services other than that related to women’s health before and during pregnancy and the actions we are taking immediately to improve maternity and neonatal care.”
The strategy does, however, include plans to prioritise health education in schools, communities and healthcare settings to “empower women” with the “knowledge and tools they need to help control their fertility” and “prepare for the best pregnancy outcomes.
It also promises to provide women with access to “safe and high-quality contraception, abortion care, fertility services, preconception care and support after pregnancy loss in convenient settings.
Scotland is set to publish the UK’s first dedicated miscarriage patient charter, giving women and families clear information on NHS care and support.
Commissioned by the Scottish Government and developed with baby-loss charities Tommy’s, Held In Our Hearts and the Miscarriage Association, the charter sets out minimum standards for compassionate, clinically appropriate and culturally competent miscarriage care across Scotland.
It builds on the Scottish Government’s Delivery Framework for Miscarriage Care, which has already changed practice across NHS boards.
Jenni Minto, Scottish public health and women’s health minister, said: “Miscarriage is devastating, and for too long women have not had the care and support they deserve.
“That is changing. Scotland will become the first country in the UK to publish a miscarriage patient charter, meaning women know exactly how they will be supported by health services following their loss.”
Unlike previous UK-wide norms, where women were typically offered enhanced support only after three miscarriages, Scotland’s approach means women can receive appropriate support after their first miscarriage.
The charter also sets out clear rights and expectations so every woman, regardless of location or circumstance, understands the care she should receive.
It includes access to private rooms in hospitals rather than busy clinical areas or maternity settings, progesterone treatment where clinically appropriate, compassionate and culturally competent bereavement support, and clear information in 18 languages, including British Sign Language and audio formats.
Progesterone is a hormone that growing evidence suggests may help reduce the risk of miscarriage in certain cases when given to women who meet specific clinical criteria.
The Scottish Government said the charter is designed to ensure personalised, respectful care and to address long-standing inequalities experienced by women during miscarriage.
It is intended to provide clarity on the support women can expect, consistent standards across all NHS boards, stronger awareness and confidence among healthcare professionals, and better access to emotional and practical support services.
Charities involved in its development said many women still report feeling dismissed, uninformed or unsupported during miscarriage.
They said the new charter marks an important step towards making sure every woman feels heard, respected and cared for.
The charter aligns with Scotland’s wider Women’s Health Plan, which is improving care across reproductive, menstrual, maternal and perinatal health.
Recent national developments include greater investment in women’s health services, improved training for healthcare staff, new digital and in-person support tools, and targeted action to reduce inequalities in access and outcomes.
Together, these measures aim to create a more compassionate and equitable women’s health system.
Minto said: “This charter is a landmark moment.
“It tells women clearly what they should expect from their NHS, and it holds services to account for delivering it.
“Scotland is leading the way, and I am proud of the progress NHS boards and our charity partners have made together.”
The model is expected to inform wider UK discussions on miscarriage support, bereavement care and early pregnancy services.
The charter will be made publicly available, offering women, partners and families clear guidance on their rights and the standards they can expect when seeking care.
By Adrianne Nickerson, founder and CEO, Oula
The numbers get the headlines. Maternal mortality rates. Access deserts. Workforce shortages. These are real and urgent problems, but they’re not the whole story.
There’s a quieter breakdown happening inside routine appointments, and it’s driving outcomes in ways that never show up in formal reports.
Women describe maternity care that feels rushed and transactional.
They talk about repeating their medical history at every visit, leaving appointments with questions they never got to ask, and receiving advice so generic it doesn’t seem to account for their actual lives.
These aren’t just complaints about bedside manner. They’re signals that the system is losing the thread, and when that happens, clinical risk follows.
A patient who doesn’t feel heard may decide a new symptom isn’t worth mentioning.
A patient who leaves an appointment without clear next steps may wait too long to call when something changes. These small moments of disconnection are where complications quietly take shape.
The system is structured to rush
This isn’t about individual clinicians failing women. It’s about a care model built around short, physician-led visits with limited coordination across roles — applied to pregnancies that are often medically and emotionally complex.
Clinicians are covering more ground in less time, and patients feel that compression. Women in marginalised communities feel it most acutely.
Reports of dismissal and bias are well-documented, and the consequences compound: when trust erodes, communication breaks down, and the window for early intervention narrows.
What women are actually asking for
Younger women in particular are entering maternity care with different expectations. They want explanations for recommendations, not just instructions.
They want to understand tradeoffs and have their preferences carry forward from one visit to the next. They’re not looking to reduce medical oversight, they’re looking for care that makes sense as a whole.
That’s driving real interest in collaborative care models that bring OBs, midwives, nurses, and behavioural health professionals into a coordinated framework.
When roles are clear and communication is shared rather than siloed, the experience changes, and so do outcomes.
Experience is clinical performance
Health systems are sophisticated at tracking infection rates and readmissions. The experience of care deserves the same level of attention, because it’s often where the clinical picture first starts to slip.
The fixes aren’t mysterious. A longer first visit can prevent confusion that compounds over months. Integrated mental health support surfaces concerns that might otherwise go unspoken.
Clear communication across the care team eliminates the mixed messages that erode confidence.
Postpartum services like pelvic floor therapy and lactation support – when easy to access and clearly explained – extend the impact of care well beyond delivery.
Workforce shortages and financial pressure make all of this harder. They also make it more urgent.
When women feel respected and informed, they raise concerns earlier, follow care plans more consistently, and seek help sooner.
That’s not a soft outcome – that’s how complications get prevented.
Simply put: adjusting how care is delivered is one of the most direct ways to improve clinical outcomes.
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