UK must do more to meet its CEDAW obligations on trafficking and prostitution

Maternity Action is the UK’s leading charity committed to ending inequality and improving the health and well-being of pregnant women. While we might not seem like an obvious charity to take an interest in Article 6 of CEDAW which addresses trafficking and prostitution, an increasing area of work for us in recent years has been supporting pregnant migrant women who are facing charges for NHS maternity care, as well as women who find themselves destitute during pregnancy, and the theme of Violence Against Women and Girls (VAWG), including prostitution and trafficking, is a thread running through this work.

While Maternity Action’s interest in CEDAW has mainly been in relation to Article 11 (Employment) and Article 12 (Health), our advice work has made us increasingly aware of the links between prostitution, trafficking, poverty, pregnancy and access to healthcare. Many of the women who seek the support of Maternity Action have been trafficked to the UK for the purposes of prostitution or domestic servitude. Some are pregnant as a result of sexual violence, survival sex, or coercion.

CEDAW is unequivocal that trafficking and prostitution are issues that must be addressed if states are to eliminate discrimination against women. Article 6 states that:

States Parties shall take all appropriate measures, including legislation, to suppress all forms of traffic in women and exploitation of prostitution of women.

As with many underground and criminal activities, it is impossible to accurately estimate the numbers of women being trafficked into the UK, with traffickers apparently undeterred the Modern Slavery Act.

The reality is that not only are government policies failing to stop trafficking or to address the harms caused to women and girls by prostitution, they are in fact making worsening the poverty that often drives women into prostitution or “survival sex” and they are further punishing women if they become pregnant by charging them for NHS care.

Maternity Action has been contacted by women seeking advice regarding NHS charges for maternity care who tell us they’ve been forced into exchanging sex or domestic work in return for a bed and food. In these situations, women reported that food was sometimes withheld or that they were only allowed to leave the house when undertaking errands.

One woman who contacted Maternity Action for advice recently was living in such poverty and was so hungry that she had agreed to have sex with a man in exchange for a takeaway meal. She had become pregnant as a result and, due to a complex pregnancy and labour, now faces a bill of over £10,000 for her NHS care.

Maternity Action’s research into NHS charges for maternity care in 2018, What Price Safe Motherhood?, included interviews with women who had been trafficked to the UK and others who had become pregnant while they were “sofa surfing” as they were homeless. The report explained that;

“Many women reported that to support themselves they had moved from place living with ‘friends’. This is also often referred to as ‘sofa-surfing’. These terms may be euphemisms for transactional sexual relationships or domestic work in exchange for shelter. Such sexual relationships have also been characterised as ‘survival sex’ – “the exchange of sex for accommodation and/or other material support.”

Although there are exemptions in the NHS charging regime for victims of trafficking, we know from the women that we speak to that there is a great deal of shame and stigma attached to trafficking which prevents women from contacting the authorities. Some are fearful of reprisals. One woman told us her family would kills her if they found out she had been trafficked into prostitution. Because these women are not known to the authorities as victims of trafficking, they are unable to claim an exemption from charging.

Home Office and local authority dispersal policies further exacerbate the vulnerability of these women by moving them to areas where they are isolated from any support networks they may have had.

Maternity Action welcomes the CEDAW committee’s concluding observations to the UK government this year which specifically called for action to protect vulnerable women from sexual exploitation and “sex for rent” arrangements.

We fully support the CEDAW committee’s recommendation to the UK government to;

“Take effective measures to ensure that women in vulnerable situations have effective access to employment opportunities, housing and social security so that they do not need to resort to prostitution or “sex for rent”.

Read more about the links between NHS charging, pregnancy, and VAWG (including trafficking and survival sex) in Maternity Action’s new report A Vicious Circle: The relationship between NHS charges for maternity care, destitution, and Violence Against Women and Girls.


Scarlet Harris is Head of Policy and Campaigns at Maternity Action. Maternity Action is the UK’s leading charity committed to ending inequality and improving the health and wellbeing of pregnant women, partners and young children – from conception through to the child’s early years.