Miscarriage rates 40% higher in black women

[ArabellaScott]

www.bbc.co.uk/news/health-56889861

Shocking report.

'The Lancet analysis of data on 4.6 million pregnancies in seven countries suggests being black increases miscarriage risk by 43%.'

Agree that the scant evidence makes it hard to know how to approach or address the headline issue. However, at least a call for more research and time spent addressing miscarriage in general is a good start.

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

Also

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.

@AssessmentTsunami

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.

I absolutely agree. It's a shocking indictment of poor maternal care for WOC.

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.

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.

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)?

@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.

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

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

@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.