A group of campaigners and lawyers have launched an urgent inquiry exploring the possibility that alleged systemic racism in the UK’s National Health Service (NHS) is impacting maternal health outcomes for ethnic minority women.
The inquiry, launched on Monday, is being organised by the nonprofit Birthrights, a human-rights oriented campaigning group advocating for better experiences of pregnancy and childbirth, and comes after research revealed significant racial disparities in the numbers of women dying in childbirth.
The findings, published in December 2020 by a coalition of health researchers called MBRRACE-UK (Mothers and Babies: Reducing Risks through Audits and Confidential Enquiries), found that Black women are four times more likely to die in childbirth compared to white women.
Meanwhile women from Asian and mixed minority ethnic backgrounds face twice the risk of dying in childbirth than white women, the report revealed.
The lead author of the report, Marian Knight, professor of maternal and child population health at the University of Oxford, said in January that while deaths in childbirth are uncommon in Britain, the difference could be a sign of racial disparity in the numbers of women experiencing serious problems during pregnancy.
“Maternal mortality is uncommon so while there is an unacceptable racial disparity, even for Black women the rate is low,” she said. “But what is significant is the statistics are likely to be a marker of similar disparities in severe pregnancy complications and what we call ‘near misses’.”
Excited and honoured to be part of this panel for @birthrightsorg inquiry on racial injustice & human rights in maternity care.— Sabrina Stewart (@Sabulous) February 7, 2021
Everyone deserves safe, fair and respectful maternity care regardless of their race. https://t.co/89UgSkmzdy
The Birthrights inquiry is being led by the barrister Shaheen Rahman QC, who told the Guardian: “In addition to these stark statistics there are concerns about higher rates of maternal illness, worse experiences of maternity care, and the fact Black and Asian pregnant women are far more likely to be admitted to hospital with COVID-19.”
“We want to understand the stories behind the statistics,” she continued. “To examine how people can be discriminated against due to their race and to identify ways this inequity can be redressed.”
The issue of racism in maternal health care was brought to national attention in July 2020 when 24-year-old YouTuber Nicole Thea died while 8-months pregnant, sparking a debate about how often Black women’s health issues go undiagnosed or untreated.
The racial disparities have also been highlighted by Sunday Times bestselling author of I Am Not Your Baby Mother, Candice Brathwaite, who has written candidly about her own traumatising experience of giving birth and the racism she experienced at the hospital, which contributed to health complaints going ignored.
Joining Rahman in the inquiry are two co-chairs with personal experiences of the issue: Benash Nazeem, the director of the Association of South Asian Midwives, and Sandra Igwe, a campaigner who set up the Motherhood Group, a social enterprise supporting Black mothers.
Nazmeen said from her knowledge and experience as a midwife and aunt to 13 children, there are “too many concerns that need to be unpicked and addressed.”
Leigh Day is proud to support this inquiry alongside @birthrightsorg - it is both essential and long overdue to investigate disproportionate health outcomes in maternity care for ethnic minority groups @LeighDayHealthhttps://t.co/RnLpLdRY3g— Leigh Day (@LeighDay_Law) February 7, 2021
According to Nazmeen, these issues include "repeated questions based on racial stereotypes, unsafe antenatal conversations due to cultural and communication barriers, and the appalling statistic that Pakistani women are more likely to have a premature baby or neonatal death in the UK compared to their country of origin."
Igwe said she first experienced racism in maternal health care during a pregnancy appointment, eventually leading to a letter of apology from the hospital. Then when she was in “active labour”, as in the final stage of labour before birth, her cries for help were dismissed as being “rude” — it was only when the baby’s heart rate dropped to a low level that did she receive care. The experience later triggered postnatal depression, Igwe explained.
Amy Gibbs, the chief executive of Birthrights, said that the inquiry will “take the starting point that racism exists in society so it must exist in the NHS.”
“We know many health care workers provide safe, respectful care to everyone, regardless of their ethnicity. But the evidence shows persistent inequities in maternity outcomes and experiences," Gibbs continued. “We want to understand how racial bias and systemic racism impact on people’s basic rights in pregnancy and childbirth, so we can be honest about the harms being caused and what needs to change.”