Black women in England are still facing poorer outcomes in their maternity care due to systemic racism, alongside failures in leadership and data collection, according to a group of MPs.
Across the UK, black women are more than twice as likely to die in childbirth compared with their white counterparts, while babies born to black mothers are at an increased risk of stillbirth.
A report by the health and social care committee found that these disproportionately poor outcomes in maternity care for black women were due to a combination of factors including systemic failures in accountability and leadership, with black women’s concerns “not taken seriously” due to bias, stereotyping and racist assumptions.
“Safe maternal care for Black women depends on a workforce that listens to, understands and respects their needs,” according to Paulette Hamilton, Labour’s MP for Birmingham Erdington and acting chair of the committee. “Leadership must be effective but it must also be accountable. This report proves that this is not, currently, the case.”
She added that the government’s upcoming investigation into NHS maternity care must be a “turning point” for black women in particular. “In-built structural racism in maternity services repeatedly fails Black women. Acknowledging this and addressing racial disparities in maternal outcomes must be one of the investigation’s core aims,” she added.
The rate of maternal death in Black womenThe rate of maternal death in Black women
The committee also found that given these disparities, it was “indefensible” that cultural competency training was not mandatory for NHS staff working across maternity services. They urged the government, the Royal College of Midwives and the Nursing and Midwifery Council to make the training compulsory for all staff, and that the training should be informed directly by the experience of black women.
Inadequate data collection was also cited as a factor for the ethnic disparities across maternity care, with the committee finding that a significant number of individual NHS trusts were failing to consistently record this information, and that this lack of robust data resulted in a system being “blind to its failings”. As a result, the committee also urged the government to accelerate development of a maternal morbidity indicator, which it has already committed to producing.
The report comes after previous findings by the advocacy group Five X More, which found that almost half of pregnant black women raised concerns to healthcare professionals during labour, with half saying that their concerns were not properly addressed.
Tinuke Awe, a co-founder of Five X More, said that the committee report was welcomed, and that there was an “urgent need to tackle systemic failings in maternity care” for black women.
Awe added: “For too long, Black women have been ignored in maternity care, and the recommendations in this report highlight that change is overdue. We believe now is the time to act. Fix it for Black women, fix it for all women.”
Clare Livingstone, the head of policy and practice at the Royal College of Midwives, said that black women being at greater risk during pregnancy and childbirth was a “disgrace”.
“The recommendations in this report must be acted upon urgently and everyone in maternity services must work together to tackle these shocking disparities,” Livingstone said. “It should not be the case that these inequalities exist in England today.”
A Department of Health and Social Care spokesperson said:“Racism in any form is completely unacceptable and we are determined to reduce the shocking disparities that this report addresses.
“We’re already taking action to improve maternity care, including launching an anti-discrimination programme, training thousands more midwives, and introducing new standards to tackle leading causes of maternal mortality.”
