Half of black women in UK who raise concerns during labour did not receive suitable help

[IwantToRetire]

Maternity experiences of more than 1,000 pregnant people found black women up to four times more likely to die in childbirth

https://www.theguardian.com/society/2025/jul/21/half-of-black-women-in-uk-who-raise-concerns-during-labour-did-not-receive-suitable-help-study-finds

I know there have been other threads about this on FWR, but cant seem to find them. Only to say that the situation still seems to be as bad as it was a year ago(?)

I work in maternity. The team here is ethnically diverse; there is a specialist midwifery team for BAME women and yet black women particularly have worse outcomes and frequently report feeling unheard.

Sorry if it's already been linked while I was posting.
This Parliamentary Report came out a few years ago.
https://publications.parliament.uk/pa/cm5803/cmselect/cmwomeq/94/report.html#heading-1
8. The reasons for ethnic disparities in mortality are not fully understood. Across aggregated ethnic groups, women are dying from the same causes, but Black and Asian women are dying more frequently.31 We heard that there were many possible reasons for the disparity in the frequency of deaths, including pre-existing conditions and co-morbidities; socio-economic factors including deprivation; and factors impacting on the care that women received, including ignorance, bias, microaggressions and racism

There have been attempts to discuss this on BMN over the years, but there's always those who land on that Board and disrupt discussions. It happens here also.

That is true @KittyWilkinson . I honestly do not know what is wrong with posters like that.

Yes it would be good to be able to talk about it on a Feminist Women's Rights forum, which of all places should be able to have an informed and supportive discussion.

Not having a thread hijacked,

And from earlier threads and analysis it isn't just that Black women are facing racism in maternity units, but somehow over the years information about possible pre conditions or other factors, somehow keep being ignored rather than intigrated into support aimed at this group of women.

As with any other women with a common factor.

Maybe that is the racism.

Not thinking it important enough to drawing up guidelines or advice for those providing support.

I don’t understand your figures or how any of it relates to the OP.

-There are nearly 100 different nationalities living in London.
-60% of Londoners were born in the UK.
-The largest group of non-UK nationalities in London is people born in Europe.

• The maternity stats OP is talking about concern British women so I'm not sure what relevance your points about languages has.

Helpful data here https://trustforlondon.org.uk/data/country-of-birth-population/

I worked in an indigenous community where there was a great project to train indigenous doulas (and midwifes etc. but that takes longer). Having someone there who can advocate and knows the system (and can be a witness and everyone knows it) helped. I wonder if the NHS could use some of that malpractice money and fund something similar.

The awful truth is that women’s healthcare is already shitty, and Black people’s healthcare is worse, and Black labouring mothers are in the most fatal part of that Venn diagram.

https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/parentscountryofbirthenglandandwales/2023#main-points

In 2023:

31.8% of all live births were to non-UK-born mothers in England and Wales (an increase from 30.3% in 2022); this continues a general increase in the percentage of live births to non-UK-born mothers.

37.3% of live births were to parents where either one or both were born outside the UK, increasing from 35.8% in 2022.

India remained the most common country of birth for non-UK-born mothers and fathers, with Pakistan remaining second.

London remained the region with the greatest proportion of births to parents where either one or both were born outside of the UK (67.4% of live births).

Wales and the North East of England had the lowest proportions of births to parents where either one or both were born outside of the UK (17.5% and 20.5% of live births, respectively).

The proportion of births to parents where either one or both were born outside the UK has been increasing across all regions.

Not sure how up to date this list is but some groups working or campaigning on this issue:

https://www.tommys.org/pregnancy-information/support-service-black-women/resources

Oh the wonders of FWR, you learn something new every day.

Who would have thought that cities in the UK are more ethnically diverse than towns and countryside.

Stunning revalation.

It’s not just poverty.

The stats are broken down so a white woman in an affluent area has better outcomes than a white woman in a deprived area.

BUT even black women in affluent areas have worse outcomes than white women in deprived areas and black women in deprived areas is even worse.

The NHS is systematically racist. As a midwife I had to educate myself on how to recognise jaundice in a non white baby, I was never taught this. All the medical text books show white babies only. There are many things that are treated differently depending on skin colour and this is a huge area that is not taught and as such they receive worse care.

It’s so basic, and not as if dark skins are remotely unusual anymore b

https://www.cuh.nhs.uk/news/childbirth-pain-relief-study-reveals-inequalities-for-bame-mothers/

• For vaginal births, Bangladeshi-British (by 24%), Pakistani-British (by 15%) and black Caribbean-British (by 8%) women are less likely than white women to receive an epidural.
• Black women are approximately 40% less likely to have an assisted vaginal birth (forceps/ventouse [suction] delivery) compared to white women but instead are more likely to have an emergency caesarean birth.
• Black Caribbean-British women in the UK are 58% more likely than white women to be given general anaesthesia for elective caesarean births; for Black African-British women, they are 35% more likely to have general anaesthesia.
• For emergency Caesarean births, black Caribbean-British women are 10% more likely than white women to be given general anaesthesia.

Edited to add that these are BRITISH women referred to in this study.

From the above survey.
There is a need to listen better to women from ethnic minorities so as to avoid health professional misconceptions and presumptions about women’s expectations and experiences of their perinatal care.
Dr James Bamber

More here if anyone is interested.
https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/10.1111/anae.15987

Has the service been audited as to why?

If it’s not outing, is it likely to be one of the 10 in the investigation?

@RethinkingLife the service does get audited. The BAME midwifery team was set up in response to the fact that we know BAME women suffer poorer outcomes and generally feel less satisfied with their maternity experience.

There's so much I could say here but do feel it would be too outing.
I will say at our trust the vast majority of the obstetric and medical team are BAME. Of the senior obstetric team the majority are not British born and trained and practised outside of the UK before coming here. I make this point because I don't think it's as simple as saying the NHS is systemically racist as one poster above suggests. These doctors of ours are highly experienced and trained and worked in countries where the population is predominantly black/brown...so they are fully aware of how symptoms present in darker skin vs white skin for example.
Our midwifery team on the other hand is roughly 70% white British. However I've noticed the proportion of black women coming through as midwifery students is increasing; with one recent cohort 7/8 were black British.

It is but it’s overlooked.

Some examples from my student years. We are taught about the importance of vitamin D supplementation in pregnancy. No one ever mentioned that darker skins have higher vitamin D requirements and so need a higher dose. Learnt that myself later.

I often heard the ‘strong black woman’ rubbish touted to justify black women needing less pain relief.

This is going back a fair few years but even now I’ve witnessed people rolling their eyes when a patient has an interpreter. I understand it because often you have the same amount of time allocated to that woman and it obviously takes longer but that means the woman ends up not getting all the information because the midwife is rushing.

We did an audit recently of all the non english speakers booked for care at our hospital. Do you know how many of them phoned the triage number during their entire pregnancy? ONE! Do we think they never had reduced movements, never had any concerns or is it that they can’t access that service? We’ve now launched a walk in service for women who don’t speak English so they are told they can just turn up. But how many other trusts still have the phone up before coming advice?

You are misunderstanding me.

I am not saying the staff are racist. I am saying the SYSTEM is racist. Look at how the training is delivered using examples on white patients, white patients in medical text books, have you ever seen a black CPR dummy? And again the example of phoning triage that my trust just audited.

Coronation Street has done a recent storyline raising awareness about this after DeeDee, a woman of Caribbean heritage, almost died from pre eclampsia after being repeatedly patronised and dismissed by midwives. I know it's fiction but it's awful that this reflects the reality for so many women who are just not listened to.

@BarkItOff i did GCE and Alevel Biology. We talked about foods enriched with vitamins- margarine having vitamin d because of rickets, and poor light levels in this country, and its particular importance for immigrant families that wouldn’t be aware of the increased need in our grey country. I also saw a programme encouraging Asian mothers to cook with margarine instead of Ghee because of the vit d

Maybe I just had interesting science teachers- it does sound like a bit of an aside now I think about it.

My area is one of those under investigation I think. A baby in our village was stillborn, I believe they found failures in care.

It’s just a constant refrain on here, that women are receiving poor care. That is bad enough in itself, before you add in particular groups getting care that’s even less adequate.

That’s fab. I like to think it’s getting better as my training was years ago now as I said.

But then it was only 2 years that a black woman died in pregnancy and racism was found to have contributed to the cause.

www.bbc.co.uk/news/uk-england-merseyside-68300655.amp

Listen I don't disagree with the examples you have highlighted. Heck, I am sure as hell across the NHS you'll find racist staff members! The entire field of medicine is sexist! We've known this forever!
My point was, (which I probably didn't articulate very well), is that the disparities in maternal health, that black women experience, stem from a complex interplay of many different factors including, biology, systemic biases, socioeconomic issues as well as overt and subtle racism. It's not as simple as saying its systemic racism:- address this and problem solved! It's multifaceted; its complicated. And it's very shit. 😔

Black women are the immigrants most likely to speak English fluently. Language isnt the issue here.

Also prejudice between non-white communities or more specifically, anti-black racism/misognoir exists. So having a "BAME" team in no way makes black women safer. In fact, there are also issues where all staff prioritise the care of the most affluent groups as part of defensive practice. This becomes more of a problem as the demand on scarce resources increases and the people with the loudest voices can ensure they are heard first.

Personally, the things that have alienated people I know from maternity services stem from cultural differences and ethnocentricity. It has led to them being reluctant to ask advice or share concerns because much of what they know and say will be rubbished as old wives tales or plain ignorance.

Why do you find it easier to accept that "the field is sexist" vs "the field is racist"? Why do we not just have "sexist staff members", too?

Maybe women just don't speak English well enough or are intrinsically weak and unhealthy, hence the difference in outcomes that some perceive as systemic sexism. Could just be some bad apples.

I personally think maternity is in free fall and that all the principles of patient care are ignored. How many examples do we hear of/share both on MN and IRL sbout women being ignored in childbirth. The majority on here are white women, just be virtue of demographics.
when we know that black women are most likely to be subject to racism of any group it therefore should be no surprise that this translates into maternity.
The devastating consequences are shown in the statistics and desperately need to be tackled urgently