Rayah Feldman, Maternity Action
Maternity Care Charging Impact Report

Chargeable women are typically either visitors to the UK who may or may not be able to pay NHS charges, or undocumented migrants, typically overstayers, who have no rights to work or to benefits. 
Most of destitute women featured in the study had been in the UK for several years, in some cases over 10years, and had found themselves in financial hardship or destitute after failure of immigration applications meant that they were no longer able to work.

Others were brought to the UK by abusive partners or traffickers on whom they were completely dependent, but from whom they have since fled or been abandoned. Some women in the case examples still live with husbands or partners with whom they came, or whom they met in the UK.

Many of the women often already faced serious financial problems before any charging took place, which meant that they had little or no realistic expectation of repayment. Most, if not all, the cases identified should be considered as high risk pregnancies, and therefore treated with increased vigilance. In practice, however, it found that anxiety over
charging, and of being reported to the Home Office because of consequent debts to the NHS served as powerful deterrents on women to accessing care. 

Given the known vulnerabilities of migrant women who are chargeable for maternity care, this study, as an initial scoping exercise, suggests that there is a need for further and more in-depth investigation of the impact of charging for maternity care on migrant women and their families.