Black, non-white, and mixed ethnicity backgrounds consistently face inequalities in health care, recent research has revealed.
Studies have highlighted that women, who identify as black or of black mixed heritage, report negative experiences with healthcare professionals – more often than their white peers. These experiences are often grounded in racial biases that impact their health outcomes.
Racial inequalities in UK maternity care are further brought to light by a nationwide survey by Five X More, a grassroots campaign committed to improving maternal health outcomes of black women in the UK.
The May 2022 publication titled “The Black Maternity Experience Survey” was designed to help address the urgent need to understand how black women’s maternity experiences influence their perception of care throughout the antenatal, labour, and postnatal period.
The study gathered qualitative and quantitative data on the individual experiences of 1,340 women of black or black mixed heritage who accessed NHS maternity services between 2016 and 2021.
Dr Michelle Peter (a social scientist) and Reyss Wheeler (a social research consultant) served as the Black Maternity Experiences Survey authors—with the co-founders of Five X More, Tinuke Awe and Clotilde Abe, acting as peer researchers.
According to the survey:
The Black Maternity Experience Survey findings add detail to inequalities that have been documented for years. Other studies show that black women in the UK:
- Are twice as likely to have a stillbirth than white women
- Are 5 times more likely to die during pregnancy or shortly after
- And that babies born to Black or Black British parents had a 67 per cent increased risk of neonatal death compared to babies of white ethnicity.
What Does This Mean?
The Five X More survey authors suggested that their findings ‘raise cause for concern’—with the negative experiences outweighing the positive. These negative experiences were centred around 3 constructs that influenced the behaviour of healthcare professionals:
- Knowledge: This includes a poor understanding of the physiology or anatomy of black women and how clinical conditions present in their babies.
- Attitudes: Using racially offensive or discriminatory language or dismissing concerns raised.
- Racially based assumptions: e.g., relationship status, education, and pain tolerance.
The healthcare professionals’ attitude, knowledge, and assumptions had long-lasting emotional, clinical, and psychological consequences for the black and black mixed women—with many of them reporting that their experiences had left them “traumatised” and fearful of childbirth.
“…during the C-section the epidural wore off and I informed the anaesthetist…The anaesthetist failed to tell the surgeons, so they carried on despite me screaming and crying in pain…It was extremely traumatic…I’ve since had another baby and the mental struggle to bring her earth side was horrendous,” recounted one woman.
“My whole birthing experience and aftercare has put me off having another child,” added another.
What Is the Way Forward?
The stark disparities in maternal outcomes are clear, yet these racial inequalities are still apparent today. Black women in the UK are still experiencing a lower quality of care, often with devastating consequences.
“Inequalities in maternal death rates between black women and white women in the UK have been documented for many years, and it is thanks to the work of Five X More and other advocates that tackling this disparity is now recognised as a priority. It is only by listening to women that we can understand the full impact of the care we are providing and identify ways to improve,” said the Professor of Maternal and Child Population Health at the University of Oxford, Marian Knight.
The co-founder of Five X More, Tinuke Awe, added: “The findings in this report highlight the urgent work needed to ensure that rapid improvements are made – because a positive birthing experience is deserved not just by some, but by all.”
According to respondents from the Five X More survey, the maternity care for black and black mixed women can be improved through:
- Better Communication: “When a woman expresses concern about her health or her baby’s health…take your time to listen to her concerns and anxieties without making assumptions.”
- Training and Educating Healthcare Professionals: “Staff need to be aware of unconscious biases and stereotypes that can influence their behaviour. This is not about people being malicious or intentional, but rather about how societal norms about racism have shaped us.”
- Investment into Further Research: “There needs to be more research-based on black women and this used to train healthcare professionals rather than using research based on white women’s bodies and birth experience and forcing us to fit those “norms”
- Valuing the Experiences of Black and Black Mixed Women: This includes treating them with the same empathy, compassion, and dignity as women from other ethnic backgrounds.
- Improving engagement and awareness of ethnicity-related maternal health risks
The Black Maternity Experience Survey concluded with the following recommendations:
- An annual maternity survey targeted specifically at black women
- Improve the quality of ethnic coding in health records
- Increased knowledge on identifying and diagnosing conditions that are specific to and disproportionately affect black women
- More community-based approaches must be used to improve maternal outcomes
- An improved system for women to submit their feedback and/ or complaints specifically for maternity
- Ensure that individuals involved in training health care professionals are aware and have an appreciation of the disparities in maternity outcomes.
The survey brought the experiences of black women in the UK’s maternal care system to the fore by listening to their perspectives. It is now the responsibility of the medical profession and all areas of society, to tackle the issue of systemic racism in UK maternity care and safeguard the health of all women and children.
Compensation For Mistakes Made During Childbirth
If you feel that the care you or your child received prior to, during or after birth was negligent, you may decide to bring a maternity claim in order to secure justice and compensation for yours and your child’s injuries. Speak to one of our medical negligence solicitors who specialise in birth injury claims.
Devonshires Claims support victims of medical negligence by providing:
- A free no-obligation case evaluation
- A no win no fee agreement
- A network of medical experts and specialist medical negligence barristers
- Over 20 years’ experience in securing justice and compensation