One of the most shocking and frightening elements of the systemic racism that exists in society is the Black maternity scandal. Only last year, in the wake of the Black Lives Matter protests did the bare facts come to light that in the UK if you are a Black woman you are 5x more likely than white women to die during pregnancy, childbirth and up to 6 weeks post-partum; being mixed race means being three times more likely to die during pregnancy and up to six weeks after birth. Despite the UK being a relatively safe place to give birth – just under 1 in 10,000 women suffer a maternal death – the low rates bely the worrying disparity and Black women are 4 x more likely than white to suffer maternal death. Last night, in an important Channel 4 Dispatches documentary, TV presenter and singer Rochelle Humes explored why these appalling statistics exist and what can be done to incite the urgent change needed to address the situation.
Here’s 9 things we learnt from the documentary.
1. A 2020 government report “regrets” the disparity in death between white and Black women, but “has no target” to end it.
In November last year the UK joint human rights committee released a report called “Black people racism and human rights” in which it was reported that
Black women were at that time 5x more likely than white women to die during pregnancy, childbirth and up to 6 weeks post-partum. Asian women are 2 x more likely to suffer maternal death during pregnancy and up to six weeks after birth. Rochelle reads from the report:
“The NHS acknowledge and regret this disparity but have no target to end it”. Rochelle repeats the finding before reading: “The government must introduce a target to end the disparity in maternal mortality between black women and white women.” But has that that target been introduced she asks? “I don’t want to assume that this information is being parked but it does just look like numbers she observes.
2.“If the system knows there’s a problem and we’re just going to put that on the shelf, we haven’t got any plans, as a Black woman my life is not being prioritised. It’s just not fair”
says Rachael Buabeng, founder of the mothers’ support group and Instagram account mummys_day_out who describes the mood amongst her fellow Black community as a “grieving feeling”.
3. Maternal deaths only tell part of the story.
Many women in the UK are living with consequences of having survived a serious or life-threatening complication during pregnancy, child birth or shortly after. These are referred to as ‘near misses. Rochelle visits Jade, a mum of three daughters and a ‘near miss’. After Jade’s first birth she ended up haemorrhaging and needing a blood transfusion. After an elected and uncomplicated C section for her now 21-month-old twin girls, it was the events after the birth that were a ‘bit of a daze’ for Jade. She recounts how after receiving for morphine for pain and despite her husband’s repeated pleas for help, it was only after 12 hours that they did a scan on her stomach to discover litres of blood inside. “Within three or four minutes I was then in theatre, as it was a life or death situation” she recalls crying. “Would I have been shown more empathy if I was white? Possibly yes. Am I fearful of being that strong opinionated person because I am Black and I don’t want to come across as aggressive, I guess when you sit here and the whole reality of was I not listened to because of the colour of my skin? That cuts really deep” says Jade.
4. Compared to white European women, Black African women are 83% more likely to suffer a ‘near miss’ in childbirth and Black Caribbean women are 80% more likely in the UK.
“If white women were dying at these rates they’d damn well do something about it and they’d do something now,” says Mars Lord, a doula who tells Rochelle how she notices a difference between how her white patients are treated during pregnancy and childbirth to how her Black patients are treated. “Black women aren’t given choices in the same way,” she says.
5. Experts have known about this scandal for years, but no one has acted.
“We’ve been counting these numbers for years but nobody was doing anything about it” says Professor Marion Knight from Oxford University who runs the research body Embrace UK,
6. Black and Asian women are subject to a ‘constellation of biases’ that white women are not
, states Professor Knight who points out that in the course of their care they may not be listened to or be subject to micro-aggressions. “We describe it as being a case of ‘not like me’ and not necessarily appreciating the culturally sensitive care that women need,” says Knight.
7. A US study reported that some medics believe (falsely) that Black people can bear more pain than white people.
Rochelle asks if the same thing could be happening in the UK? Last summer The Royal College of Obstetricians and Gynaecologists set up its race and equality task force aimed at tackling inequalities and racism in women’s healthcare. Co-chair, Dr Christine Ekechi believes more nuance is needed when it comes to talking about why Black women may be prone to certain conditions.
“What tends be offered as a reason [for this disparity] is that Black women are more likely to have the health conditions that put them at greater risk, they’re more likely to be overweight for example they’re more likely to have hypertension so we tend not to actually ask ‘why?’ and often the answer is that being racialised in society means that you are in the lower rungs of society which means you are more likely to have these conditions,” she says, adding, “Even if you are middle class and black my race still means that the way society and the world interacts with me, I am still at greater risk of those poorer outcomes.”
8. Only within the last year has the conversation around Black maternal health gained mainstream attention.
Rochelle interviews the founders of the 5 x campaign – who are lobbying the government to urgently address this scandal – and they point out that it was only in the wake of the BLM resurgence following the death of George Floyd in June last year that the true extent of the disparity was brought to light. A petition they launched which now has 187,000 signatures has led to a scheduled debate in the House of Commons.
9. A maternal ‘continuity in carer’ system pioneered at Newham hospital in east London hospital is seeing early positive results in reducing poor maternal outcomes.
But across the board, maternal care is still not set up for diverse women in the system. “We’re lucky to have the NHS but the maternal mortality rates are a stark reminder of the wider racial inequalities in society and until these issues are fixed, reducing the disparities feels a long way off, says Rochelle. In a statement to Dispatches, Nadine Dorries, Minister for Maternity said: “The colour of a woman’s skin should have no impact on her baby’s health. I am absolutely committed to tackling disparities and making sure all women get the right support and best possible maternity care. I have launched an oversight group to monitor how the health service is tackling inequalities.”