‘Racism endangers maternal health’
REPORT SHOWS BAME WOMEN MORE LIKELY TO DIE IN PREGNANCY OR CHILDBIRTH
TACKLING racism in maternity wards will help reduce the number of women from ethnic minorities who currently die during pregnancy or childbirth, according to England’s chief midwifery officer.
Black women are four times more likely than white women to die in pregnancy or childbirth, while Asian women face a twofold risk and women living in the most deprived areas of the UK are almost three times more likely to die than those in the most affluent areas.
These are findings from a 2021 report from the MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries).
“I do think that we need to focus on racist behaviour, and who listens to who, because I think if we unblock that, then we’ll be well on our way to improving outcomes for everybody,” said professor Jacqueline Dunkley-Ben.
She was speaking during a panel discussion at the NHS Race and Health Observatory’s Health, Race and Racism International Conference 2022 in London earlier this month.
In 2016-18, 547 women died during or up to a year after pregnancy from causes related to their pregnancy, among 2.2 million women who gave birth in the UK.
In that period, 34 black women died among every 100,000 giving birth, compared to 15 Asian women in 100,000, and eight white women in 100,000.
The report said these figures were ‘fundamentally unchanged’ from those documented in the 2019 report and that, despite encouraging responses to this disparity from groups, including the NHS and government agencies, sustained focus was needed.
“The data tells us the gap in inequality and health outcomes is reducing. However, data obscures the human experience. So regardless of the rate, regardless of the number, there is something about stepping into that space, changing the narrative and doing something differently,” said Dunkley-Ben.
Dunkley-Ben said she is leading some of the strategies implemented by the NHS, which include maternal medicine clinics and perinatal mental health services. “It’s really important to change the narrative. Look back to learn, but stepping into new territory to move forward, because we need to move the dial in a different way,” she said.
Chair of the panel and senior vice president at the Commonwealth Fund, Laurie Zephyrin, said: “We’ve seen it through the data that black mothers have been more likely to die than white mothers for about a century, for as long as we’ve had data collected. We have to really understand that we need an intentional focus on eliminating these inequities. It’s not a matter of ‘let’s raise all boats’, we really have to understand the root causes of these inequities and intentionally address them.”
Two panellists agreed that one of the ways to eliminate equalities at the root cause was to make changes within the education system for trainee midwives.
“We have to remember that the curriculum is essentially white; it doesn’t account for a lot of conditions and the way things present in black skin,” said Tinuke Awe, a black maternal health campaigner and co-founder of Fivexmore, an organisation which supports black women to make informed choices and advocate for themselves throughout their pregnancies and after childbirth.
“So you might be bringing in more black midwives or more black professionals, but if they are all learning something from a Eurocentric nature, then nothing will change.”
Professor Benash Nazmeen, assistant professor of midwifery at the University of Bradford, added: “We’ve spoken earlier about how important it is to be culturally competent in our practice.
“So bringing that into our education system would really improve the role of the midwives and be able to help them improve some of these outcomes.”