Miscarriage rates 40% higher in black women

@EmbarrassingAdmissions yes it was me and another poster who pointed out pelvic shape variations impacts labour and birth.

Thank you for pointing out this thread to me. The figures for miscarriage amongst black women is astonishing. 40% is high.

There's an inquiry here www.research.net/r/racialinquirymaternity in to the disparity in outcomes for black mothers and their babies.

This is so shocking but I'm glad to see it getting some press. I hope progress will be made on this.

I think I've found the thread that I had in mind and it was @dinosauratemydaffodils and @plumpuddisnice who discussed pelvis shape:

Apparently only 50 percent of women have gynecoid (what's typically described as a female pelvis) pelvises…Then of course there is the link between pelvis shape and longer labours which can lead to more interventions…[and] when discussing maternal inequalities, it's definitely relevant.

Gestation can also varies on race. Black babies tend to be ready earlier than white ones which I imagine can cause issues with our western view of overdue/term. Induction may be fine for a white baby at 42 weeks, less so for a black/asian one. Will see if I can find the study I read about that later.

Basically using a white woman as a standard template for western obstetrics is bad. Maternity care needs to centre the individual

www.mumsnet.com/Talk/womens_rights/4193378-Black-Mothers-Matter-Non-profit-supporting-black-women-during-pregnancy?pg=3

@EmbarrassingAdmissions it could have been me. There are lots of examples that are all going to affect decisions and subsequent outcomes.

Women’s health is woefully underfunded. The acknowledgment that there are racial differences and we need to invest in research outside of the western world are steps in the right direction.

Lilyofthevalleys - was it you who posted some interesting information about relevant differences in the pelvis - and this is based on a default in the UK that doesn't match the reality of some women (crudely, by some heritage criteria)?

Having worked in this field I appreciate that social and health care access and responses are contributory. But the fact that there are genetic and physiological differences between different races that affect pregnancy are often not addressed. An obstetrician I collaborated with from Uganda, working in a teaching hospital with 32 000 deliveries a year, said that all the teaching materials and evidence used to train obstetricians was based on white women. Yet women of African origin have in average shorter gestation for example.

pubmed.ncbi.nlm.nih.gov/15075154/

The genes that regulate implantation (and have been implicated in miscarriage) are at different frequencies in African populations.

www.pnas.org/content/112/3/845

More money and focus needs to go on having more diverse study groups that inform treatment and obstetrics training going forward.

Miscarriage is so often shrugged off as 'just one of those things' but it can be devastating and women need care and advice after their 1st one - we shouldn't have to wait until we've had 3 in a row to trigger intervention.

This is just unacceptable. What with this and the high rates of black maternal mortality that was recently reported - it’s shocking. We need to really push for a proper overhaul of maternity services and serious investment. I know it’s not just a case of throwing money at it either - some serious tackling of racism and prejudice within every strata of the NHS.. Even if there is a particular prevalence of diabetes or other contributory health factors, the outcome need not be the same. Proper healthcare, monitoring, listening to pregnant black women when they have concerns - all have to play their part.

Also

Yes Arabella, if we don't know what the causes are then more research is needed. Targeted solutions needed.

In the UK there is virtually no healthcare to access in early pregnancy!

The recommendations in the report are mainly about investigations etc and look familiar, eg they’re investigations available from a small number of recurrent miscarriage clinics.

Re maternal mortality, there is some discussion about the most recent MBRACE report in relation to race and ethnicity here:

www.aims.org.uk/pdfs/journal/804

I think black women are more reluctant to access healthcare more than white women. A combination of factors including not being listened to; just recently there were reports r.e. Black women having higher mortality rates in pregnancy too.

But it could also be related to other health or cultural factors. Which would have different solutions. Or maybe some is even things like differences at the genetic level (I don't think that is going to account for 40% mind you but it could be a factor, there can be genetic differences that make a difference in these kinds of health differences.)

There isn't much to do unless there is more information.

Without understanding the reasons for this dreadful statistic, you. Ant tackle the inequality.

Completely awful as are the rates of deaths of women from BAME communities in childbirth.
We know this so why is there so little action by the NHS?

This is absolutely horrific. What an emotional and physical toll on women that number signifies.

I can't believe that figure but given that men are the default and medication, research is all male centric, perhaps the issues with black women and pregnancy would be dealt with better in a system that works for women. Appalling figure

That's a dreadful number. I hope that more can be done to address this.

This should not be happening.40% higher is a shocking statistic.

I saw this today. Shocking

But the reasons some places do it less often is in part because what you are supposed to do about it is pretty much what you are supposed to do anyway, which is eat more carefully, and there are some differences in approach to neonatal care that make it less relevant too I think. Though I think it's controversial.