Charity no. 1151152
# **Birthrights Report and Unaudited Financial Statements**
**31 March 2023**
## **Birthrights**
## **Reference and administrative details**
## **For the year ended 31 March 2023**
|**Charity number**|1151152||
|---|---|---|
|**Registered office**|Birthrights||
||Union House||
||111 New Union Street||
||Coventry||
||CV1 2NT||
|**Trustees**|The trustees who served during the year and up to the date of this report||
||were as follows:||
||Alix-Louise Anderson||
||Tara Arnold||
||Rachel Crasnow QC||
||Inderjit Cross||
||John Davis|Treasurer|
||Julie Frohlich|Resigned 26 July 2022|
||Carolyn Johnston|Resigned 26 July 2022|
||Marcia Lord||
||Dr Ria May Clarke|Appointed on 26 July 2022|
||Simon Mehigan||
||Sandra Nneoma Igwe||
||Elizabeth Prochaska|Chair|
||Rebecca Schiller|Resigned 8 November 2022|
|**Chief executive officer**|Amy Gibbs|Resigned 14 July 2022|
||Tracey Fletcher|Interim CEO appointed 11 July 2022|
||Shanthi Gunesekera|Appointed 3 January 2023|
||Janaki Mahadevan|Appointed 3 January 2023|
|**Patron**|Nadine Montgomery||
|**Bankers**|The Co-operative Bank||
||Olympic House||
||6 Olympic Court||
||Montford Street||
||Salford||
||M5 2QP||
|**Independent**|Godfrey Wilson Limited||
|**examiners**|Chartered accountants and statutory auditors||
||5th Floor Mariner House||
||62 Prince Street||
||Bristol||
||BS1 4QD||
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
## **1. Introduction**
In January this year, we celebrated 10 years since Birthrights was founded. We are proud of what we have achieved in that time, turning a tiny volunteer-led charity into the leading voice for women’s rights in pregnancy and childbirth in the UK. Despite the increasing recognition and acceptance of people’s rights in maternity care, our work has never been more urgent: maternity services are facing an unprecedented workforce crisis, the pandemic continues to affect people’s experience of care and racial inequity still has a devastating impact on Black and Brown women and birthing people.
The past year has been an exceptional year for Birthrights: we published our inquiry into racial injustice in maternity care, which revealed systemic racism in maternity services. The report brought a much needed focus on how race affects people’s maternity experiences and we are committed to continuing to hold maternity services to account to achieve real change.
Our brilliant CEO, Amy Gibbs, left in the summer, after providing outstanding leadership to Birthrights for 3 years. We were very grateful to Tracey Fletcher, our interim CEO, for seeing Birthrights through the following 6 months and providing strong support to our team. In January, we welcomed our new joint CEOs, Shanthi Gunesekera and Janaki Mahadevan. We are thrilled to be able to model a job share at CEO level and we hope it will provide inspiration to other charities. Our new CEOs have huge ambitions to grow Birthrights’ reach and impact and it is a privilege to work with them as we enter the next decade.
## Elizabeth Prochaska (Chair)
The trustees present their report with the financial statements of the charity for the year ended 31 March 2023.
Reference and administrative information set out on page 1 forms part of this report. The financial statements comply with current statutory requirements, the Constitution and the Statement of Recommended Practice - Accounting and Reporting by Charities (effective from January 2019).
## **2. Welcome from our Co-Chief Executives**
By championing the rights of women and birthing people throughout pregnancy and birth, we are working to ensure those currently going through their maternity journey feel supported, safe and heard. But we are also fighting for a system that will respect the bodily autonomy of our children and generations to come.
For years, the voices and decisions of women and birthing people in the UK have been ignored and dismissed. From Morecambe Bay to Shrewsbury and Telford, there is evidence that a failure to listen to women and birthing people results in trauma, discrimination, coercion and violence and, in far too many cases, tragedy.
But in the UK and around the world, women and birthing people are standing up and fighting for reproductive justice and against the erosion of their reproductive rights.
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
We are honoured to have joined Birthrights at this critical time, leading Birthrights into its next decade.
This year’s annual report shows the real difference Birthrights has made for women and birthing people who have accessed our information and advice, for healthcare professionals who have attended our training, and through our research to understand the stories behind the stark statistics of racial discrimination and a broken system.
We look forward to building on these strong foundations to fight for maternity systems that work for everyone in the UK, so women and birthing people feel heard, supported and safe throughout their pregnancy and birth, and are enabled to make decisions about their body and care that are respected.
Shanthi Gunesekera and Janaki Mahadevan, Co-Chief Executives
## **3. Gratitude**
We express deep gratitude to everyone who contributed to our Race Inquiry and the subsequent groundbreaking report _Systemic Racism_ , _not Broken Bodies_ , the expert panel of obstetricians, midwives, experts by experience, academics, birth workers and lawyers, overseeing the inquiry, and to all the women and birthing people who contributed to the inquiry including over 300 Black, Brown and mixed ethnicity women and birthing people who gave evidence. Thanks to the co-chairs of the Panel - Shaheen Rahman QC, Sandra Igwe and Benash Nazmeen, and to former CEO Amy Gibbs and Race Inquiry lead Melissa Brown for their tireless work in supporting the panel, gathering evidence and doing so in a way which recognised and was mindful of the trauma experienced by those contributing their experiences of maternity care.
We are also grateful to Pamela Abiola, Ese-Roghene Agambi, Adelaide Harris and Nova Reid whose generous wisdom, expertise and robust challenge, enabled us to root this work in anti racist principles and practice, ensure we took a trauma informed approach to evidence gathering, and enabled us to scope and communicate our work effectively. We could not have reached so many women and birthing people without support from our fellow charities and community organisations, who helped to recruit and co-facilitate focus groups: the Happy Baby Community, the Raham Project, the Swansea Women’s Asylum Seeker and Refugee Group, the African Community Centre, the Latin American and Iberian Association and Leeds NHS Trust Maternity Voices Partnership.
Thank you to all our funders and corporate partners for their generosity and belief in both the Race Inquiry and our wider work in 2022/23: Bolt Burdon Kemp, Esmee Fairbairn, Irwin Mitchell, John Ellerman Foundation, Joseph Rowntree Charitable Trust, Leigh Day and Thirty Percy.
A huge thank you to everyone who so generously donated to Birthrights either directly or through The Big Give Christmas Challenge, our incredible runners in The Royal Parks Half Marathon and those who supported them.
Our work is only possible because of the incredible talent and dedication of our staff team and associate trainers who have demonstrated such commitment to championing the rights of women and birthing people throughout a rapidly changing external context, and changes to Birthrights leadership team. And a particular thank you to interim Chief Executive Tracey Fletcher for guiding Birthrights through this transition in 2022.
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
Thank you to our Clinical Advisory Network who bring a wealth of expertise and experience to help inform our work.
And finally, a huge thank you to all Birthrights’ supporters for standing with us to champion the rights of women and birthing people throughout pregnancy and birth. Together we can fight for a world where women and birthing people’s bodily autonomy and informed decisions about their care are respected.
## **4. Structure, governance and management**
Birthrights is a charitable incorporated organisation and is registered with the Charity Commission with charity number 1151152.
The method of recruitment and appointment of trustees is set out in its governing document: the constitution. Three trustees stood down between 1 April 2022 and 31 March 2023 - Julie Frohlich, Carolyn Johnston and Rebecca Schiller. One new Trustee Dr Ria Clarke was appointed in July 2022, taking the Board to 10 members.
The current trustees comprise two senior lawyers, a frontline obstetrician, a Director of Midwifery, a finance and business expert, experienced charity leaders, communications and fundraising specialists, doulas and anti racism campaigners. Most trustees have lived experience of maternity care and five are Black and Brown women.
The trustees are responsible for making decisions on the management of all the affairs of Birthrights, including deciding on how the funds of the charity are to be spent. The trustees have a duty to identify and review the risks to which the charity is exposed and to ensure appropriate controls are in place to provide reasonable assurance against fraud and error. The full board of trustees met four times during 2022 to 23. The Finance, Audit and Risk Committee also met four times in this period.
## **5. Objectives and Activities**
## **5.1 About**
Birthrights launched in January 2013. We are the UK charity that champions respectful care during pregnancy and childbirth by protecting human rights. We believe that everyone is entitled to respectful maternity care that protects their fundamental rights to dignity, autonomy, privacy and equality. We provide free advice and legal information to women and birthing people, train healthcare professionals and birth workers to deliver rights respecting care and campaign to change maternity policy and systems. Our research shines a spotlight on those most at risk of human rights violations in pregnancy and birth due to structural disadvantage and discrimination.
Our vision is to ensure everyone receives the respect and dignity they deserve in pregnancy and childbirth. Our mission is to be the authority on human rights in pregnancy and childbirth in the UK and use that influence to improve services and practice throughout the maternity system.
Birthrights promotes legal rights to receive evidence based care that conforms to the best medical and midwifery standards. We do not promote any particular clinical perspectives in maternity care.
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
## **5.2 Aims**
The aim of Birthrights is to promote the human rights of child bearing women and people in England and Wales. These rights are set out in the Universal Declaration of Human Rights, the Convention on the Elimination of Discrimination against Women and subsequent United Nations conventions and declarations, and the European Convention for the Protection of Human Rights and Fundamental Freedoms.
## **5.3 Activities**
Birthrights is committed to:
- promoting awareness of the legal rights of child bearing women and people during and connected to pregnancy, childbirth and the postnatal period (the six weeks subsequent to birth);
- promoting respect for the legal rights of child bearing women and people among healthcare organisations, medical and other professions and in society at large;
- protecting the human rights of child bearing women and people through the provision of legal information and advice and obtaining redress for victims of human rights abuse;
- campaigning in relation to human rights and related legal issues relating to child bearing women and people;
- responding with technical advice to proposed legislation and policy affecting child bearing women and people;
- providing technical advice to government and others on human rights and other legal and regulatory matters as they affect child bearing women and people;
- contributing to the understanding and sound administration of human rights law as it affects childbearing women and people, in particular, but not exclusively, through third party interventions in legal cases;
- promoting the human rights and lawful treatment of child-bearing women and people by commissioning and conducting research;
- providing education and training to, among others, parents and parents to be, healthcare professionals and the public on human rights and the law as it affects child bearing women and people;
- eliminating infringements of human rights of child bearing women and people; and
- ▪ undertaking other charitable activities that the trustees may from time to time determine to promote the human rights and legal status of child-bearing women and people.
When planning our activities for the year, the trustees have considered the Charity Commission’s guidance on public benefit and, in particular, the specific guidance on charities for the promotion of human rights.
## **6 Achievements and Performance 2022/23**
## **6.1 Information and Advice**
_"Amazing advice, I cried reading her email (happy tears) in thoughts that there might be some hope for what I would like my labour and birth to look like for me and my baby"_
Our email information and advice service is grounded in a deep understanding of the law and how it relates to maternity care. We combine this with a commitment to provide trauma informed and empathetic advice and information about rights to women and birthing people, and those supporting them, alongside practical advice about how to raise complaints and advocate for themselves in discussions with healthcare professionals.
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
We continue to see the voices of women and birthing people routinely ignored or dismissed within the maternity system, and Trusts and Hospitals continue to implement policies that do not take account of individual need; suspend or restrict access to core maternity services; and do not respect informed decision making and bodily autonomy.
Within this context, the power of the information and advice Birthrights provides to ensure the experiences and decisions of women and birthing people are heard and validated and to lift up, support and empower women and birthing people is clear in the feedback we receive:
_"You guys were amazing and only people that listened to me"_
_"It has given me reassurance that when I start my journey into motherhood I’ll be able to make choices that are right for me and my pregnancy. It is also comforting to know that your organisation exists to guide me, should I encounter any hiccups along the way."_
_"It was really affirming to read "hard" evidence that what happened to me was wrong and not just necessary at the time."_
_"Thank you for your help and support and knowledge and information you gave me. I honestly believe it was because of this my problem was finally sorted out."_
_"I cried with relief and truly feel this will make such a difference to my mental well-being "_
_"Thank you so much for your email. I cried when I received it. The information you have provided has been really useful thank you."_
_"I doubt that the conversation would have been as productive and successful if I had not contacted yourselves."_
_"Your response really helped me fight my case with and I’m so grateful for that! It’s so important that expectant mums feel they have a place to turn to for support."_
_"I felt empowered and ready to stand up for the birth I deserve."_
It is crucial that our staff team have both the physical and emotional capacity to respond to increasingly complex and traumatic accounts they receive through the information and advice service. In 2022/23 in response to the changing nature of enquiries coming through to us, we increased capacity within the service to enable the team to respond to and carefully manage complex enquiries, including those about lack of consent, birth trauma and racism so as to ensure each team member’s emotional wellbeing is safeguarded.
Enquiries to our information and advice service remain at almost three times the number that Birthrights received in 2019 to 2020. We saw a slight drop (13%) in the basic numbers of enquiries on our information and advice service (from 1,112 to 969) which corresponds to the end of the pandemic and to the end of enquiries about the fundamental right to a birth partner or the right to decline Covid testing for appointments (key themes for the past two years).
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
However, the nature of the advice service changed markedly with a larger number of women and birthing people who had given birth during the pandemic, particularly at the height of restrictions, wanting to complain about the poor nature of their care and human rights breaches. Complaints, particularly about consent and birth trauma, made up the highest volume of all enquiries across the year. Very often, these are detailed and complex complaints which require dedicated, personalised and trauma informed responses. In many cases, women and birthing people, particularly those identified as not speaking English as a first language, as neurodiverse or from marginalised communities, will share their birth trauma story and require personalised support, information and practical advice in how to set this out as a formal complaint. People who are already within the complaints process, often send the team any response they receive to their complaint which is dismissive of their lived experience and defensive over a breach of rights. The team then offers practical advocacy advice on how to respond further and/or escalate the complaint further to the Trust or to the ombudsman and other regulator.
We have also seen a significant increase in the number of queries about unassisted birth, home birth and choice of place of birth compared to 2021 to 2022. This signals a post covid landscape shift in people choosing to give birth outside of the hospital and the issues that arise when trying to make this lawful choice. Primarily these revolve around the lack of staffing for midwifery led units to remain open, a lack of staffing and service provision for home births, and a lack of clarity in the legalities of unassisted birth and the processes for registering a baby after an unassisted birth. Enquiries related to access to medical notes increased as more people want to see their notes as they complain.
Notably and concerningly we saw a 100% increase in enquiries about referrals to social services. A number of these were about vulnerable women and birthing people already working with social services, facing further allegations of neglect on the basis of them declining routine examinations or the offer of an induction during their pregnancy.
We continue to review how we increase our reach to more women and birthing people. In 2022 to 2023 we trialled blog posts on key issues such as home birth, which led to an increase in engagement with our information and advice. But we know there is potential for us to grow our service to reach more women and birthing people in 2023 to 2024 and beyond. Only half of the women and birthing people using our service currently share their demographic information with us - of those who do we know that 80% identify as “White British”.
## **6.2 Online Resources**
In addition to our information and advice service, we have a number of factsheets on our website setting out the latest information on women and birthing people’s rights during pregnancy and birth, where they come from in law, and how they are backed up in guidance.
Our factsheet on right to a caesarean section continues to be our most popular with over 40,000 unique page views in 2022 to 2023, with factsheets on human rights in maternity care and choice of place of birth around 20,000 unique views each, and factsheets on accessing your records and unassisted freebirth over 16,000 unique views each.
## **6.3 Training**
_"The training has made me feel more confident supporting people in all situations and evaluating my own practice - it’s reminded me why I’m a midwife and I’m so grateful."_
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
We provide training to frontline healthcare professionals in NHS trusts and hospitals, as well as doulas and birth support workers on how the law relates to maternity care. Our training is always provided by two trainers - one with legal expertise and the other with clinical experience. We draw on our experienced staff team and a cohort of dedicated associate trainers to deliver training online and in person across the country.
The Covid-19 pandemic threw an already under resourced NHS into deep crisis. As maternity services struggle to retain staff and healthcare professionals face unsafe and poorly paid working conditions the crisis has continued. But with report after report showing that the voices of women and birthing people are ignored or dismissed, we are seeing interest in our training sessions continue to grow.
In 2022 to 2023 Birthrights ran 54 training courses which is more than double the number delivered in the previous year (22 courses). We have also seen a move towards full day sessions - in the previous year all but one of the training sessions were half day sessions; whereas this year almost a third of the training delivered were full day sessions with 17 full day and 32 half day sessions. As a result of easing Covid restrictions, this year Birthrights delivered many more in person sessions with 21 (approximately 40%) in person training sessions compared to only one in the previous year.
Birthrights does not underestimate the importance of our training being accurate, accessible and impactful – being invited into spaces to share our expertise and listen to the lived experience of healthcare professionals and birth workers is something we continue to be grateful for. With this growth in training, quality control has been key to the work of the training team. Shadowing sessions with detailed feedback have become a routine part of our programme and we are supporting our associate trainers in various ways to ensure that they feel empowered and informed to deliver Birthrights training which ensures that participants attending Birthrights training are receiving the same consistent and detailed message. We have also reviewed all of our training resources to ensure that they reflect both any updates in law, but also the current work environment in which maternity care operates. Part of our work has been developing a Padlet, which all participants who have attended our training can access, ensuring that their learning continues after the session.
In 2022 to 2023 Birthrights trained roughly 660 professionals working in maternity including 520 healthcare professionals. Those who attended training included doctors, midwives, anaesthetists, paramedics, birth workers and maternity investigators. Midwives comprised the largest profession of those trained, making up more than half of attendees. Others who attended in high numbers were doctors and student midwives, each comprising approximately 15% of attendees. Two roles that had the lowest attendance were anaesthetists and trainee doctors which comprised roughly 0.5% and 2.2% of attendees respectively.
The safe space that is facilitated during Birthrights training sessions allows us insight into how healthcare professionals are experiencing the current maternity care system (and indeed the broader experience of working in the NHS). Many healthcare professionals who attend report barriers to delivering rights-respecting care include poor working conditions, including a lack of resources and time; toxic workplace cultures, and lack of support and understanding from leadership. The experience that healthcare professionals share with us during training sessions are key to forming our approach and strategy. Women and birthing people cannot receive rights respecting care if staff do not feel safe, supported and empowered to provide it.
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
As we move forward and develop our training offer for the months and years ahead we are considering how we best target our services and wider campaigns to address the issues that we consistently hear prevent those on the frontline from delivering the care all women and birthing people have a right to receive.
The vast majority of respondents, 94% (286 out of 303), self reported that their knowledge of human rights law in maternity care increased after attending a Birthrights training session. Our evaluation asks participants to rate the overall training between 1 to 5, with 1 being poor and 5 being excellent. This data was collected from the second to final quarter of 2022 to 2023 with an average rating from this period being 4.5.
Our trainers also received consistently excellent scores. When asked to rate their performance on the same 1 to 5 scale, participants gave both our legal trainers an average score of 4.4 and our healthcare professional trainers an average score of 4.5. This is not significantly different from last year where both trainers received a score of 4.7.
Following the session 41% of attendees said they regularly encountered situations in their work they would define as human rights situations. More than half (56%) of attendees said they encountered these situations occasionally and 2% said they never have encountered these situations.
92% (349 out of 377) of respondents said that Birthrights training impacted the way they plan to work with women and birthing people (seven said “I don’t know” and 13 said “No”). While 98% (396 out of 406) of respondents said they would recommend Birthrights training to others.
Birthrights training is central to the broader culture change that is required to ensure that women and birthing people (as well as their families) are accessing rights respecting care. To ensure our training is dynamic and fulfilling this purpose, we must be looking at the long term impact to help us understand what other resources we can create to support healthcare professionals as well as women and birthing people. This year, we are beginning to follow up with those who have attended our training sessions 2022/2023 to understand if they still feel supported and empowered by that training six to 12 months on. Anecdotally, we are told by participants they have started work implementing the Birthrights message, including by reviewing guidelines, reviewing educational materials and adapting language.
_“This training was so informative and interesting to participate in, it was extremely thorough and I felt that the trainers created a safe space in which all the students could participate in. Amazing session!”_ (Student midwife)
_“Thank you for the session. It was a useful refresher of human rights in practice and really good to see the impact that Birthrights is having in maternity care. It is incredibly important to me.”_ (Head of Midwifery)
_“Absolutely brilliant day. All health professionals working with pregnant people and their families should go on this training.”_ (Digital Transformation midwife)
_“Best training I have been on for a while! Thank you for your time.”_ (Community Midwife Team Leader)
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
_“I always enjoy your sessions and the discussions created by them. I also feel that this would have been very beneficial as a junior trainee when you're forming your 'way with women' - forming good habits is much easier than breaking bad ones!”_ (Obstetrician & Gynaecologist ST6)
_“I want to finish training to be able to fully advocate for women and join Birthright’s mission to continue advocating for all women.”_ (Trainee doctor)
_“Thank you for a wonderful and insightful session into the legal aspects of human rights”_ (Specialty Doctor Anaesthetics)
_“Thank you- there was so much information and it was so helpful to be trained by people who hear real stories every day. Such valuable training for all birth workers. I would love to see this training ripple through the maternity system.”_ (Doula)
_“I would absolutely recommend Birthrights training to all obstetricians and midwives.”_ (Professional Midwifery Advocate/ Birth Options Clinic)
## **6.4 Campaigns and Influencing**
In May 2022, we published our report _Systemic Racism, not Broken Bodies_ - the culmination of the year long inquiry into racial injustice in the maternity services. The report documented the traumatic experiences of Black and Brown women who felt unheard and dehumanised through their pregnancy and birth, shining a spotlight on the stories behind the statistics.
We heard accounts of women whose worries were dismissed, including a Black woman who almost died of sepsis after healthcare professionals failed to hear her concerns or identify symptoms due to the colour of her skin. One of the most common experiences described in the testimonies we received was of Black, Brown and mixed ethnicity women and birthing people’s pain being ignored or denied, and of pain relief being withheld due to disbelief among staff that labour had begun.
The key themes that appeared from the testimonies of women and birthing people were:
- racial microaggressions and stereotyping;
- failure to recognise serious medical conditions due to skin colour; and
- lack of respect for culture and religion, breaches of consent, and trauma.
From healthcare professionals we heard about:
- the NHS culture of blame and fear;
- lack of diverse senior representation; and
- direct witnessing or experience of overt racism – with no process or protection to escalate concerns.
In contrast, our Inquiry heard that positive accounts of maternity care focused on good communication, person centred and culturally sensitive care. This emphasises the critical importance of upholding the principles of respectful, individualised care and effective communication.
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
Based on the evidence gathered through the inquiry, together with our expert panel we identified five calls for all parts of the maternity system:
- commit to be an anti racist organisation;
- decolonise maternity curriculums and guidance;
- make Black and Brown women and birthing people decision makers in their care and the wider maternity system;
- create safe, inclusive workforce cultures;
- dismantle structural barriers to racial equity through national policy change.
Our report has been downloaded nearly 5,000 times and we continue to have press interest in this work and have featured in different media outlets (including Women's Health, Grazia, Vogue, the Guardian, the BBC and the Lancet).
We have also spoken publicly about the report throughout the year to key organisations and events, including: Saving Babies Lives, National Childbirth Trust (NCT) Lunch & Learn, NHS England Nuggets, CORE20Plus5 connectors online learning event and the NHS England Maternity Transformation Programme stakeholder council meeting. Our team were also invited to speak in Parliament at the Maternity Disparities Taskforce and at the APPG for Black Maternal Health, and our co chairs Sandra Igwe and Benash Nazmeen have spoken on the reports findings at more than 100 different events including conferences, podcasts, on TV and at workshops and seminars. Within the Maternity sector our findings have been widely reported and commented on, including by: the Royal College of Midwives; Patient Information Forum online; the British Medical Journal; the Royal College of Obstetricians and Gynaecologists; Nursing in Practice; Patient Safety Learning; Maternity and Midwifery Forum; and the Nursing and Midwifery Council.
We gave evidence to the Women and Equalities Select Committee in March 2022 as part of its 2022 to 2023 report into Black maternal health, published in April 2023, leading to another surge of interest in Birthrights’ work in this area.
The Race inquiry continues to be held up by stakeholders as a rich body of evidence which looks at the drivers of the stark inequities of maternity experiences and outcomes. Birthrights has held meetings with the National Midwifery Council, Royal College of Midwives, the Equalities and Human Rights Commission and the National Institute for Health and Care Excellence about how they plan to incorporate the asks from the report into their organisational strategies and to seek future prospective collaborations. This demonstrates the opportunity for our charity to hold institutions to account, make them reflect on their work and practices, and explore ways we could work together to improve the services for Black, Brown and mixed ethnicity women and birthing people.
In September, NHS England published a full paper detailing their response to the Race Inquiry’s findings, which was discussed during the NHS England’s Stakeholder Council. We have contributed to a working group on the CQC Maternity Survey for 2023, which will be the first time the survey will consider more explicitly the disparities in care for Black, Brown and minority ethnic women and birthing people. We have also peer reviewed the proposed Royal College of Obstetricians and Gynaecologists maternity triage guidelines.
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
The unprecedented interest in the findings of the Race Inquiry report are testament to the quality of the work produced and we are indebted to the hundreds of women and birthing people who shared their experiences with us. The findings demonstrate the breadth of work and commitment to challenging racial inequity that is required across all parts of the system to build back trust, improve service provision and eliminate racial disparities in maternity care.
## **6.5 Wider Campaigning and Advocacy**
Alongside this landmark report, we also continued to mount pressure on the Government and NHS Trusts to provide safe and effective maternity care. Most notably:
- In September 2022, Birthrights led the coordination of more than 30 organisations in a letter to the then Secretary of State for Health and Social Care, Thérèse Coffey, outlining the crucial issues facing maternity service delivery and calling on the Government to make meaningful interventions to meet their 2019 manifesto commitment to make the NHS the ‘best place in the world to give birth’ a reality.
- In March 2022, we gave evidence to the Women and Equalities Committee, contributing to their final report released in April 2023 calling on the Government to set a definitive target to eliminate “appalling” disparities in maternal deaths.
- In June 2022, we gave evidence to the Health Committee of the London Assembly on the response of London maternity services to Covid-19 and on the results of our Race Inquiry. The London Assembly’s final report was issued in April 2023, highlighting the negative impact the pandemic had on the mental health of pregnant women and finding that there were clear disparities in the levels of care provided between different NHS Trusts as they took different approaches to enforcing Covid-19 restrictions.
- We submitted evidence to the Module 2 UK Covid-19 Inquiry, set up to examine the UK’s response to and impact of the pandemic and to learn lessons for the future.
## **6.6 Extending our reach through communications**
## _Press_
Throughout the year we have continued to pursue and attract high profile press coverage on a range of issues covering Birthrights work. Notable successes in terms of communicating our message to wider audiences throughout the year have included:
- Birthrights quoted in the Guardian and Birmingham Mail on the epidural shortage in September ;
- Appearance on local BBC Radio (Berkshire, Newcastle Live, West Midlands, Three Counties and Cumbria) in relation to the BBC analysis that more than half of maternity units in the UK are failing to meet safety standards;
- Our letter to the Secretary of State Thérèse Coffey received coverage in Glamour UK;
- Birthrights has been able to address the NHS staffing crisis and call for urgent Government investment through a number of media outlets, including ITV News, BBC Radio 2, BBC Radio 5 Live and BBC Radio Wales and The Times;
- We have had repeated coverage in the Guardian, covering topics such as NHS charging and caesarean birth and several local press outlets on human rights in childbirth.
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## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
## _Social Media_
We have seen nearly a 15% increase in followers on Instagram and 5% increase in followers on Twitter and Facebook in 2022/23. Having reviewed the datasets collated for social media in 2022/23, we plan to create a suite of data sets that provides consistent data across all social media types. This would focus more on engagement levels so better analysis can be undertaken on how to increase engagement with Birthrights. Based on the data we currently have available we estimate our posts made over 600,000 impressions on Twitter, 260,000 impressions on Instagram and 10,000 impressions on LinkedIn, with post engagement averaging 7.5% on Twitter and 3% on Instagram and LinkedIn. This suggests that those who are following our social media channels have a strong engagement with our content, which we will seek to build on as we look to extend our reach in 2023/24 and beyond.
## **6.7 Strengthening our organisation**
As Birthrights entered its 10th year, we focused on strengthening our foundations to support aspirations to build Birthrights reach and impact in 2023/24 and beyond.
During the year we have continued to strengthen our core areas of Advice and Training, adding increased capacity to both teams through additional hours for team members and the appointment of a Training Coordinator to support the growing Training function. Central to this has been a clear focus on maintaining and continuously striving for the highest quality in the service we offer to our clients – through our in depth responses to the complex advice queries we receive and by bringing a new process of quality assurance into our training programme to ensure consistency in approach. During the year, we have also received board approval to continue to strengthen the capacity of our fundraising, communications, policy and advocacy functions and are currently driving forward the initial phase of this recruitment process.
Throughout the year we have focussed on improving our operational arm of the charity, recognising the critical role this function plays in ensuring efficient, effective and robust systems and processes to enable the whole organisation to deliver on our mission. We have procured and implemented a new Customer Relationship Management System (CRM), partnering with Beacon to enable us to better connect and understand all of the information we have across the organisation, and to ensure that we use all of our data to provide real, tangible insight into how we are performing and where we need to improve further.
Alongside this, a wider programme of professionalising the organisation has been underway this year. Following significant employee growth last year, we have implemented a new HR employee software package to better manage our key staff data, such as sickness and absence, holidays and staff demographics. This is critical in ensuring that we are able to effectively monitor key information regarding our staff, for example retention levels and staff diversity, as well as providing a secure portal for sensitive information. Similarly, we have also partnered with HR professionals to provide regular support to the organisation, ensuring that we are fully compliant with employment law. We are also working with our partners on a full review of all organisational policies, challenging ourselves to continually rethink and build on our working practices and benefits to help to support a happy, healthy and motivated workforce. Linked to this is a new wellbeing support package that has been developed and approved by the board of trustees, and will begin implementation in the new financial year.
13
## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
This year we have also moved towards implementing better IT processes across the organisation, investing in standardised equipment for all of our staff to ensure that everyone has access to the IT they need to carry out their roles effectively whilst also ensuring that we maintain a strong level of data security control. We have also partnered with an IT specialist to drive forward our migration to Microsoft 365. This will enable us to bring together our document management, emails and virtual meeting systems and in turn provide significant financial savings to the organisation whilst also improving our internal processes.
Our key focus continued to be on securing funding for the future sustainability of the organisation in order that we can continue our vital work. Key funding secured and sustained during the year included:
- We confirmed the continuation of our valued partnerships with Irwin Mitchell and Leigh Day for the next three years;
- JRCT approved the continuation of funding £100,000 over two years to support the delivery of the next phase of the racial injustice inquiry;
- We received a one-off grant of £50,000 from Thirty Percy; We received a commitment from John Ellerman of £90,000 over two years to go towards our core funding;
- The National Lottery granted us a one off payment of £10,000 to go towards building lived experiences into our work;
- We received cost of living uplifts from Esmée Fairbairn Foundation and JRCT to be added to their existing grant funds, recognising the almost £3,500 was secured from the Women and Girls Match Fund programmes.
Diversification of our fundraising efforts also continued to be a priority for the organisation in 2022/23 as we branched out into new areas of income generation. We ran our first ever public fundraising campaign; The Big Give Christmas Challenge, which raised almost £18,000 towards the next phase of the racial injustice inquiry. The campaign also performed well on social media with the launch day reel seeing over 29,000 views and an overall campaign social media reach of over 56,000. We also began fundraising through events, placing three runners in The Royal Parks Half Marathon and securing almost £2,500 for the initiative.
## **7 Financial review**
## **7.1 Summary of income and expenditure**
In 2022/23 we secured an overall income of £423,191 compared to £350,613 in 2021/22. Restricted income changed from £106,115 in 2021/22 to £106,134 in 2022/23 however unrestricted income (including designated income) changed from £244,498 in 2021-22 to £317,057 in 2022/23. Of this overall unrestricted figure, the CEOs and Treasurer agreed to designate £207,500 of unrestricted funds for specific purposes, such as staff posts and projects. Total expenditure was £382,564 (compared to £342,450 in 2021-22) which was in line with budget expectations.
At the end of 2022, £269,478 of funds were brought forward, of which £47,300 was restricted funds from grants for planned activity in 2022/23 (due to projects being phased across multiple financial years). At the end of March 2023, £310,105 was carried forward into 2023/24, including £89,710 restricted funds, £185,657 designated funds and £34,738 general funds.
14
## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
## **7.2 Reserves**
At the end of 2022-23, we hold £34,738 in unrestricted general reserves. In addition, £185,657 of core funding has been designated by the trustees, but could be reallocated if required.
Our reserves policy states that Birthrights will hold reserves to cover three months of operating costs. A three-month reserve would allow Birthrights the opportunity, if necessary, to wind down its programme of support in an orderly and managed fashion, including paying our staff reasonable notice. The trustees believe this is the appropriate level of reserves to balance prudence and risk management against maximising the benefits the charity can deliver by not tying up too much of our funds in our reserves.
For 2023/24, three months of operating costs would be £129,642, based on our planned income and expenditure budget.
## **7.3 Going Concern**
The trustees consider that the charity will continue as a going concern for a period of at least 12 months from the date on which these financial statements are approved for the following reasons:
- The charity holds total reserves of £220,395 (including unrestricted and designated funds);
- The charity is carrying forward a significant unrestricted surplus into 2023/24 which has been designated for core staff costs; and
- The charity has grants in place which span 2023/24 and beyond.
The trustees therefore consider it appropriate to adopt the going concern basis for the preparation of the accounts, as detailed in note 1(b) to the financial statements. Fundraising will continue to be a major priority for the CEOs and senior team, to ensure sustainability and growth into the future.
## **8. Statement of responsibilities of the trustees**
The trustees are responsible for preparing the trustees' report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102: The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).
The law applicable to charities in England and Wales requires the trustees to prepare financial statements for each financial year, which give a true and fair view of the state of affairs of the charity and the incoming resources and application of resources, including the net income or expenditure, of the charity for the year. In preparing those financial statements the trustees are required to:
- select suitable accounting policies and then apply them consistently;
- observe the methods and principles in the Charities SORP;
- make judgements and accounting estimates that are reasonable and prudent;
- state whether applicable accounting standards and statements of recommended practice have been followed, subject to any material departures disclosed and explained in the financial statements; and
- prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charity will continue in operation.
15
## **Birthrights**
## **Report of the trustees**
## **For the year ended 31 March 2023**
The trustees are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the charity and which enable them to ensure that the financial statements comply with the Charities Act 2011, the Charity (Accounts and Reports) Regulations 2008 and the provisions of the constitution. The trustees are also responsible for safeguarding the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.
The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charity's website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.
The trustees are members of the charity but this entitles them only to voting rights. The trustees have no beneficial interest in the charity.
## **Independent examiners**
Godfrey Wilson Limited were re-appointed as independent examiners to the charity during the year and have expressed their willingness to continue in that capacity.
Approved by the trustees on 17 October 2023 and signed on their behalf by
Elizabeth Prochaska
J A Davis
Elizabeth Prochaska - Chair
John Davis - Treasurer
16
## **Independent examiner's report**
## **To the trustees of**
## **Birthrights**
I report to the trustees on my examination of the accounts of Birthrights (the CIO) for the year ended 31 March 2023, which are set out on pages 18 to 31.
## **Responsibilities and basis of report**
As the charity trustees of the CIO you are responsible for the preparation of the accounts in accordance with the requirements of the Charities Act 2011 (‘the Act’).
I report in respect of my examination of the CIO’s accounts carried out under section 145 of the 2011 Act and in carrying out my examination I have followed all the applicable Directions given by the Charity Commission under section 145(5)(b) of the Act.
## **Independent examiner’s statement**
Since the CIO’s gross income exceeded £250,000 your examiner must be a member of a body listed in section 145 of the 2011 Act. I confirm that I am qualified to undertake the examination because I am a member of the Institute of Chartered Accountants in England and Wales (ICAEW), which is one of the listed bodies.
Godfrey Wilson Limited also provides payroll and bookkeeping services to the CIO. I confirm that as a member of the ICAEW I am subject to the FRC’s Revised Ethical Standard 2016, which I have applied with respect to this engagement.
I have completed my examination. I confirm that no material matters have come to my attention in connection with the examination giving me cause to believe that in any material respect:
- (1) accounting records were not kept in respect of the CIO as required by section 130 of the Act; or the accounts do not accord with those records; or
- (3) the accounts do not comply with the applicable requirements concerning the form and content of accounts set out in the Charities (Accounts and Reports) Regulations 2008 other than any requirement that the accounts give a ‘true and fair view' which is not a matter considered as part of an independent examination.
I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.
## Laura May Richards
Date: 23 October 2023 **Laura Richards ACA Member of the ICAEW** For and on behalf of: **Godfrey Wilson Limited** Chartered accountants and statutory auditors 5th Floor Mariner House 62 Prince Street Bristol BS1 4QD
17
## **Birthrights**
## **Statement of financial activities**
## **For the year ended 31 March 2023**
|Note
**Income from:**
Donations
3
Charitable activities
4
Investments
**Total income**
**Expenditure on:**
Raising funds
Charitable activities
**Total expenditure**
5
6
**Reconciliation of funds:**
Total funds brought forward
**Total funds carried forward**
**Net income / (expenditure) and net**
**movement in funds**|Restricted Unrestricted
£
£
106,134
263,270
-
53,598
-
189
106,134
317,057
-
52,265
63,724
266,575
63,724
318,840
42,410
(1,783)
47,300
222,178
89,710
220,395|**2023**
**Total**
**£**
**369,404**
**53,598**
**189**
**423,191**
**52,265**
**330,299**
**382,564**
**40,627**
**269,478**
**310,105**|2022
Total
£
323,808
26,765
40|
|---|---|---|---|
||||350,613|
||||40,525
301,925|
||||342,450|
||||8,163
261,315|
||||269,478|
All of the above results are derived from continuing activities. There were no other recognised gains or losses other than those stated above. Movements in funds are disclosed in note 13 to the accounts.
18
## **Birthrights**
## **Balance sheet**
## **For the year ended 31 March 2023**
|Note
**Current assets**
Debtors
9
Cash at bank and in hand
**Liabilities**
Creditors: amounts falling due within 1 year
10
**Net current assets**
**Net assets**
12
**Funds**
13
Restricted funds
Unrestricted funds:
Designated funds
General funds
**Total charity funds**|**£**
**73,145**
**316,148**
**389,293**
**(79,188)**|**2023**
**£**
**310,105**
**310,105**
**89,710**
**185,657**
**34,738**
**310,105**|2022
£
34,631
262,892|
|---|---|---|---|
||||297,523
(28,045)|
||||269,478|
||||269,478|
||||47,300
150,898
71,280|
||||269,478|
Approved by the trustees on 17 October 2023 and signed on their behalf by
Elizabeth Prochaska J A Davis
Elizabeth Prochaska - Chair John Davis - Treasurer
19
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
## **1. Accounting policies**
## **a) Basis of preparation**
The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities in preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102).
Birthrights meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy note(s).
## **b) Going concern basis of accounting**
The accounts have been prepared on the assumption that the charity is able to continue as a going concern, which the trustees consider to be appropriate having regard to the current level of unrestricted reserves and future confirmed funding. There are no material uncertainties about the charity's ability to continue as a going concern.
## **c) Income**
Income is recognised when the charity has entitlement to the funds, any performance conditions attached to the item of income have been met, it is probable that the income will be received and the amount can be measured reliably.
Income from the government and other grants, whether 'capital' grants or 'revenue' grants, is recognised when the charity has entitlement to the funds, any performance conditions attached to the grants have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred.
Income received under contracts, sponsorship agreements or in advance of provision of training is deferred and recognised when services are delivered.
## **d) Donated services and facilities**
Donated professional services and donated facilities are recognised as income when the charity has control over the item, any conditions associated with the donated item have been met, the receipt of economic benefit from the use by the charity of the item, is probable and the economic benefit can be measured reliably. In accordance with the Charities SORP (FRS 102), general volunteer time is not recognised.
On receipt, donated professional services and donated facilities are recognised on the basis of the value of the gift to the charity which is the amount the charity would have been willing to pay to obtain services or facilities of equivalent economic benefit on the open market; a corresponding amount is then recognised in expenditure in the period of receipt.
## **e) Interest receivable**
Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the charity: this is normally upon notification of the interest paid or payable by the bank.
20
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
**1. Accounting policies (continued)**
## **f) Funds accounting**
Unrestricted funds are available to spend on activities that further any of the purposes of the charity. Designated funds are unrestricted funds of the charity which the trustees have decided at their discretion to set aside to use for a specific purpose. Restricted funds are donations which the donor has specified are to be solely used for particular areas of the charity's work or for specific projects being undertaken by the charity.
## **g) Expenditure and irrecoverable VAT**
Expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably.
Irrecoverable VAT is charged as a cost against the activity for which the expenditure was incurred.
## **h) Allocation of support and governance costs**
Support costs are those functions that assist the work of the charity but do not directly undertake charitable activities. Governance costs are associated with constitutional and statutory requirements. These costs have been allocated between cost of raising funds and expenditure on charitable activities on the basis of staff time:
||**2023**|2022|
|---|---|---|
|Raising funds|**15%**|15%|
|Charitable activities|**85%**|85%|
## **i) Debtors**
Trade and other debtors are recognised at the settlement amount due after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.
## **j) Cash at bank and in hand**
Cash at bank and cash in hand includes cash and short term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.
## **k) Creditors**
Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.
## **l) Financial instruments**
The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value with the exception of bank loans which are subsequently recognised at amortised cost using the effective interest method.
21
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
## **1. Accounting policies (continued)**
## **m) Pension costs**
The charity operates a defined contribution pension scheme for its employees. There are no further liabilities other than that already recognised in the SOFA.
## **n) Accounting estimates and key judgements**
In the application of the charity's accounting policies, the trustees are required to make judgements, estimates and assumptions about the carrying values of assets and liabilities that are not readily apparent from other sources. The estimates and underlying assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.
The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period, or in the period of the revision and future periods if the revision affects both current and future periods.
There are no sources of estimation uncertainty that have a significant effect on the amounts recognised in the financial statements.
## **2. Prior period comparatives**
|**Income from:**
Donations
Charitable activities
Investments
**Total income**
**Expenditure on:**
Raising funds
Charitable activities
**Total expenditure**
**Net income / (expenditure) and net**
**movement in funds**|Restricted
£
£
103,865
219,943
2,250
24,515
-
40
106,115
244,498
-
40,525
166,242
135,683
166,242
176,208
(60,127)
68,290
Unrestricted|**2022**
**Total**
**£**
**323,808**
**26,765**
**40**|
|---|---|---|
|||**350,613**|
|||**40,525**
**301,925**|
|||**342,450**|
|||**8,163**|
22
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
## **3. Income from donations**
|Donations
Grants > £5,000
Esmée Fairbairn Foundation
John Ellerman Foundation
Thirty Percy Foundation
Joseph Rowntree Charitable Trust
Best Beginnings
The National Lottery
The Hospital Saturday Fund
The Big Give
Gifts in kind*
**Total income from donations**
**Prior year comparative**
Donations
Grants > £5,000
Esmée Fairbairn Foundation
John Ellerman Foundation
Thirty Percy Foundation
Joseph Rowntree Charitable Trust
Best Beginnings
Kickstart Scheme
Gifts in kind*
**Total income from donations**|Restricted
£
£
-
41,065
-
97,500
45,000
-
-
100,000
59,134
-
-
2,000
-
10,000
2,000
-
-
10,205
-
2,500
106,134
263,270
Restricted
£
£
-
81,971
17,300
75,000
50,000
-
-
50,000
30,000
-
-
9,000
6,565
-
-
3,972
103,865
219,943
Unrestricted
Unrestricted|**2023**
**Total**
**£**
**41,065**
**97,500**
**45,000**
**100,000**
**59,134**
**2,000**
**10,000**
**2,000**
**10,205**
**2,500**|
|---|---|---|
|||**369,404**|
|||2022
Total
£
81,971
92,300
50,000
50,000
30,000
9,000
6,565
3,972|
|||323,808|
*Gifts in kind relate to pro bono legal advice, training, stationery, printed materials and room hire.
The charity received government grants, defined as funding from the National Lottery and the Kickstart Scheme to fund charitable activities. The total value of such grants in the year ending 31 March 2023 was £10,000 (2022: £6,565). There are no unfulfilled conditions or contingencies attaching to these grants.
23
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
## **4. Income from charitable activities**
|**Income from charitable activities**||
|---|---|
|Training, conferences and events
Other
**Total income from charitable activities**
All income from charitable activities in the year was unrestricted.|**2023**
**Total**
**£**
**51,930**
**1,668**|
||**53,598**|
|||
|**Prior year comparative**
Training, conferences and events
Other
**Total income from charitable activities**|2022
Restricted
Total
£
£
£
-
23,585
23,585
2,250
930
3,180
2,250
24,515
26,765
Unrestricted|
|---|---|
## **5. Total expenditure**
|**Total expenditure**|||||
|---|---|---|---|---|
|Staff costs (note 7)
Research participation
Legal and professional fees
Marketing and communications
Room hire
Accountancy
Staff recruitment and training
IT equipment and software
Travel and subsistence
Office costs
Insurance
**Sub-total**
**Total expenditure**
Allocation of support and
governance costs|£
36,706
-
-
-
-
-
-
1,342
-
1,015
-
39,063
13,202
**52,265**
Raising
funds|£
204,744
578
20,195
2,243
2,000
-
-
17,845
7,587
1,471
-
256,663
73,636
**330,299**
Charitable
activities|£
55,861
-
-
-
8,195
19,615
-
-
2,051
1,116
86,838
(86,838)
**-**
Support
and
governance|**2023**
**Total**
**£**
**297,311**
**578**
**20,195**
**2,243**
**2,000**
**8,195**
**19,615**
**19,187**
**7,587**
**4,537**
**1,116**|
|||||**382,564**
-|
|||||**382,564**|
Total governance costs were £16,297 (2022: £7,608).
24
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
|**5.**
**Total expenditure (continued)**
**Prior year comparative**
Staff costs (note 7)
Research participation
Legal and professional fees
Marketing and communications
Room hire
Accountancy
Staff recruitment and training
IT equipment and software
Travel and subsistence
Office costs
Fundraising
Insurance
Sub-total
Total expenditure
Allocation of support and
governance costs|£
25,177
-
1,920
-
-
-
-
168
-
-
528
-
27,793
12,732
40,525
Raising
funds|£
138,474
32,436
22,724
21,358
9,928
-
3,323
905
1,972
782
-
-
231,902
70,023
301,925
Charitable
activities|£
50,860
-
18,564
-
-
7,433
1,232
3,145
-
1,042
-
479
82,755
(82,755)
-
Support
and
governance|2022
Total
£
214,511
32,436
43,208
21,358
9,928
7,433
4,555
4,218
1,972
1,824
528
479|
|---|---|---|---|---|
|||||342,450
-|
|||||342,450|
25
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
**6. Net movement in funds**
This is stated after charging:
|Trustees' remuneration
Trustees' reimbursed expenses
Independent examiners' remuneration:
▪Independent examination (including VAT)
▪Other services|**2023**
**£**
**Nil**
**Nil**
**1,920**
**6,275**|2022
£
Nil
Nil
1,740
5,693|
|---|---|---|
**7. Staff costs and numbers**
Staff costs were as follows:
|Salaries and wages
Social security costs
Pension costs
Freelancers|**2023**
**£**
**238,139**
**14,857**
**5,111**
**39,704**
**297,811**|2022
£
192,655
12,720
4,339
4,797|
|---|---|---|
|||214,511|
No employee earned more than £60,000 during the year.
The key management personnel of the charity comprise the Trustees, Chief Executive Officer, Programmes Director and Engagement Director. The total employee benefits of the key management personnel were £127,159 (2022: £121,145).
|Average head count
Average full time equivalent|**2023**
**No.**
**13.0**
**7.0**|2022
No.
8.0|
|---|---|---|
|||5.0|
## **8. Taxation**
The charity is exempt from corporation tax as all its income is charitable and is applied for charitable purposes.
26
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
|**9.**
**Debtors**
Trade debtors
Prepayments
Accrued income
Other debtors
**10. Creditors: amounts due within 1 year**
Trade creditors
Accruals
Deferred income (note 11)
Other creditors
**11. Deferred income**
At 1 April 2022
Deferred during the year
Released during the year
At 31 March 2023|**2023**
**£**
**73,145**
**-**
**-**
**-**
**73,145**
**2023**
**£**
**761**
**2,420**
**70,995**
**5,012**
**79,188**
**2023**
**£**
**25,000**
**70,995**
**(25,000)**
**70,995**|2022
£
30,995
2,495
765
376|
|---|---|---|
|||34,631|
|||2022
£
824
2,221
25,000
-|
|||28,045|
|||2022
£
5,000
25,000
(5,000)|
|||25,000|
Deferred income relates to training invoiced in advance to be delivered during 2023/24.
## **12. Analysis of net assets between funds**
|Current assets
Current liabilities
**Net assets at 31 March 2023**|Restricted
funds
£
89,710
-
**89,710**|£
185,657
-
**185,657**
Designated
funds|£
113,926
(79,188)
**34,738**
General
funds|**Total**
**funds**
**£**
**389,293**
**(79,188)**|
|---|---|---|---|---|
|||||**310,105**|
27
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
|**12. Analysis of net assets between**
**Prior year comparative**
Current assets
Current liabilities
Net assets at 31 March 2022
**13. Movements in funds**
**Restricted funds**
Baring Foundation, Legal Action
John Ellerman Foundation
King's College London
The Hospital Saturday Fund
**Total restricted funds**
**Unrestricted funds**
_Designated funds_
C and P
Esmée Fairbairn, 2021 - 2025
Esmée Fairbairn, COVID
Leigh Day Inquiry
Peabody
Safer Beginnings
Thirty Percy Foundation
_Total designated funds_
General funds
**Total unrestricted funds**
**Total funds**
Joseph Rowntree Charitable
Trust|**funds (continued)**
Restricted
funds
£
47,300
-
47,300
At 1 April
2022
Income
£
£
1,695
-
33,226
45,000
11,588
59,134
791
-
-
2,000
47,300
106,134
14,916
-
68,635
97,500
10,886
-
7,194
8,000
4,313
-
7,479
2,000
37,475
100,000
150,898
207,500
71,280
109,557
222,178
317,057
269,478
423,191|Designated
funds
£
150,898
-
150,898
£
(1,695)
(27,747)
(33,491)
(791)
-
(63,724)
(14,916)
(68,303)
(10,886)
(15,194)
(4,313)
(9,479)
(49,650)
(172,741)
(146,099)
(318,840)
(382,564)
Expenditure|General
funds
£
99,325
(28,045)
71,280
Transfers
between
funds
£
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-|Total
funds
£
297,523
(28,045)|
|---|---|---|---|---|
|||||269,478|
|||||**At 31**
**March**
**2023**
**£**
**-**
**50,479**
**37,231**
**-**
**2,000**|
|||||**89,710**|
|||||**-**
**97,832**
**-**
**-**
**-**
**-**
**87,825**|
|||||**185,657**|
|||||**34,738**|
|||||**220,395**|
|||||**310,105**|
28
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
## **13. Movements in funds (continued) Purposes of restricted funds Baring Foundation, Legal Action**
Grant for legal costs and increased staff capacity to challenge human rights violations in maternity care due to COVID-19, through strategic litigation and other legal campaigning tactics.
## **John Ellerman Foundation**
Two year grant for Birthrights to convene a national inquiry into racial injustice in maternity care, towards delivery and staff costs, including a new post to ensure the inquiry is co produced by Black, Brown and mixed ethnicity women and birthing people.
## **Joseph Rowntree Charitable Trust**
Two year grant for Birthrights to convene a national inquiry into racial injustice in maternity care, towards delivery and staff costs, including a new post to ensure the inquiry is co produced by Black, Brown and mixed ethnicity women and birthing people.
## **King's College London**
Funding for Birthrights' contribution to a research study, looking at strengthening the disclosure of harm with women and families under NHS maternity care.
## **The Hospital Saturday Fund**
Grant funding to enable Birthrights to provide advice, training and support so that everyone receives the respect and dignity they deserve in pregnancy and childbirth.
## **Purpose of designated funds C and P**
Major donation designated for operational costs, specifically upgrading the Operations Coordinator post to Manager and creating a new Team Coordinator post to boost capacity.
## **Esmée Fairbairn Foundation 2021 - 2025**
Funding over four years towards unrestricted core costs to protect human rights in maternity care through advice, training and influencing.
## **Esmée Fairbairn, COVID**
Additional unrestricted funding to support staff and operational costs during the pandemic, designated for a new post to boost capacity to deliver our training programme for healthcare professionals and birth workers, including reviewing future delivery models.
## **Leigh Day Inquiry**
Corporate donation designated for delivery of the racial injustice inquiry, specifically expert panel payments, anti-racism expertise, focus groups, transcription, report design and polling.
## **Peabody**
Major donation designated for campaigning on COVID restrictions and to create a new video on making complaints in maternity care, co produced by people with lived experience.
29
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
## **13. Movements in funds (continued)**
## **Safer Beginnings**
Funding from the Tampon Tax to be a delivery partner (sub grantee) for the White Ribbon Alliance and Best Beginnings programme to improve maternity outcomes and postpartum safety of 70,000 women by developing specialist information, services and interventions that enable selfadvocacy in the context of obstetric and domestic violence, and female genital mutilation.
## **Thirty Percy Foundation**
Three year unrestricted grant designated for staff and operational costs, including a new senior post to lead and develop our communications and engagement work, to reach and support more women and birthing people with a diverse range of needs and experiences.
|**Prior year comparative**
**Restricted funds**
Baring Foundation, Legal Action
Esmée Fairbairn Foundation
John Ellerman
Foundation
Kickstart
King's College London
**Total restricted funds**
**Unrestricted funds**
_Designated funds_
C and P
Esmée Fairbairn, 2021 - 2025
Esmée Fairbairn, COVID
Leigh Day Inquiry
Peabody
Safer Beginnings
Thirty Percy Foundation
_Total designated funds_
General funds
**Total unrestricted funds**
**Total funds**
Esmée Fairbairn Foundation
Crisis Comms
Esmée Fairbairn Foundation
Strategy
Joseph Rowntree Charitable
Trust|At 1 April
2021
£
23,468
31,139
-
-
32,887
19,933
-
-
107,427
-
-
25,000
-
20,000
-
50,000
95,000
58,888
153,888
261,315|Income
£
-
-
9,800
7,500
50,000
30,000
6,565
2,250
106,115
25,000
75,000
-
20,000
-
9,000
50,000
179,000
65,498
244,498
350,613|£
(21,773)
(31,139)
(9,800)
(7,500)
(49,661)
(38,345)
(6,565)
(1,459)
(166,242)
(10,084)
(6,365)
(14,114)
(12,806)
(15,687)
(1,521)
(62,525)
(123,102)
(53,106)
(176,208)
(342,450)
Expenditure|Transfers
between
funds
£
£
-
1,695
-
-
-
-
-
-
-
33,226
11,588
-
-
-
791
-
47,300
-
14,916
-
68,635
-
10,886
-
7,194
-
4,313
-
7,479
-
37,475
-
150,898
-
71,280
-
222,178
-
269,478
At 31 March
2022|Transfers
between
funds
£
£
-
1,695
-
-
-
-
-
-
-
33,226
11,588
-
-
-
791
-
47,300
-
14,916
-
68,635
-
10,886
-
7,194
-
4,313
-
7,479
-
37,475
-
150,898
-
71,280
-
222,178
-
269,478
At 31 March
2022|
|---|---|---|---|---|---|
||||||47,300|
||||||14,916
68,635
10,886
7,194
4,313
7,479
37,475|
||||||150,898|
||||||71,280|
||||||222,178|
||||||269,478|
30
## **Birthrights**
## **Notes to the financial statements**
## **For the year ended 31 March 2023**
## **14. Related party transactions**
There were no related party transactions in the current year. In the prior year trustee donations made to the charity were £25,000.
In the prior year two trustees received payment of £2,800 for their participation in an advisory panel, along with external contributors.
31