"Black women are five times more likely to die than white women during pregnancy and childbirth. This is a longstanding issue rooted in systemic racism, not individual failings." Elsie Gayle, Midwife
Black women in the UK are five times more likely to die during pregnancy or childbirth compared to white women. This horrifying statistic, highlighted by Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK), reflects more than just healthcare failures—it exposes deep-seated systemic issues, ingrained biases, and a lack of urgency in addressing disparities that have persisted for decades. The question we need to ask is: Why is this happening, and why hasn't more been done?
Despite the UK having one of the most advanced healthcare systems in the world, Black women, Asian women, and women of mixed ethnicity face significantly higher risks during pregnancy. These disparities have existed for over 20 years but have only received widespread attention since 2018. Why is it that in 2024, we are still grappling with these inequities?
A Legacy of Neglect
A report revealed that NHS trusts in Greater London paid out over £8.5 million in damages due to stillbirths caused by negligence over the past decade. The worst offender, Barking, Havering, and Redbridge NHS Trust, saw 22 stillborn babies due to negligence between 2012/13 and 2022/23, with pay-outs totalling nearly £1 million. The same trust faced legal fees of £120,092, while claimants’ legal fees amounted to £851,456. King's College Trust, another significant offender, paid out over £1 million in damages.
These play outs highlight systemic failings that are disproportionately affecting Black women and their babies. Beyond the negligence, what is often missing is culturally competent care that listens to and respects Black mothers. From being stereotyped as having a higher pain threshold to not receiving timely care for pre-existing conditions such as hypertension and diabetes, Black women are consistently being let down by the system.
The MBRRACE-UK report emphasises how Black, Asian, and mixed-ethnicity women face higher risks in maternal health. Black women are more likely to die from complications that could have been managed or prevented with better care. The same disparities exist for Asian women, who are nearly twice as likely to die during pregnancy compared to their white counterparts.
Impact on Confidence, Trust, and Access to Care
For Black and Asian women, these statistics have an immeasurable impact on their confidence and trust in the healthcare system. When Black women enter the hospital, they often carry the weight of these disparities with them, wondering if their pain will be acknowledged, if their concerns will be taken seriously, or if they will leave the hospital alive.
This erosion of trust affects whether women feel empowered to advocate for themselves during pregnancy and childbirth. Many are hesitant to speak up for fear of being dismissed or judged, and this silence can cost lives. Furthermore, data from Five X More indicates that 42% of Black and Asian women feel discriminated against during their maternity care, citing race as a primary factor.
If these issues are not addressed, we will continue to see the devastating consequences of a system that does not work for everyone. It is not enough to just survive childbirth—every woman, regardless of race, deserves to thrive.
The Role of Practitioners and Communities: We Can’t Afford to Stay Silent
The burden of change lies on both the healthcare system and the Black community. Healthcare providers must take immediate steps to address the racial bias ingrained in their practices. Mandatory training on racial bias, better monitoring of high-risk pregnancies, and ensuring that culturally competent care is provided at every stage of pregnancy are critical steps. There is a need to follow guidance set out by the NHS Equity and Equality framework, which mandates local maternity systems to focus on improving maternal outcomes for Black, Asian, and mixed-ethnicity women.
At the same time, the Black community must stop being "armchair revolutionaries." We can no longer afford to stand by while our women are subjected to substandard care. We must mobilise and advocate for policy changes, demand accountability, and ensure that our mothers, sisters, and daughters are protected.
We can learn from international approaches, like those led by Professor Dorothy Roberts and midwife Jenny Joseph in the USA, who are developing sustainable models of maternity care that focus on addressing racial disparities. Here in the UK, midwifery organisations like Mimosa Midwives are pushing for these same goals.
A Call for Urgent Action
The healthcare system must:
Address Racial Bias: Health professionals must recognise the unique challenges Black, Asian, and mixed-ethnicity women face and adjust care accordingly.
Implement Equity Plans: NHS trusts must be held accountable for implementing the Equity and Equality Action Plans, which focus on improving outcomes for Black and Asian women.
Improve Data Collection: Ethnicity data must be accurately recorded to ensure transparency and drive policy changes. Without this, it’s impossible to monitor progress.
Incorporate Continuity of Care: Ensuring that women receive continuous care from the same healthcare provider throughout pregnancy can significantly improve outcomes, especially for those from marginalized groups.
Black History Month: The Perfect Time to Demand Change
As we celebrate Black History Month, we must recognise that the fight for equality is not over. We cannot afford to ignore these statistics or pass the responsibility onto someone else. Black mothers deserve more than just awareness campaigns—they deserve action.
We must take this moment to move from awareness to change. Share this blog, engage in conversations, and demand policy reforms. We must push for better maternity services, increased accountability, and most importantly, a healthcare system that values Black lives.
Let’s use the momentum of Black History Month to remind the world that #YouBelongHere, and we will not stop fighting for the safety, dignity, and health of Black mothers.
Like, share, and comment to amplify the voices of Black mothers and bring much-needed attention to this urgent crisis in Black maternal health. By spreading awareness, we are not just advocating for reform; we are fighting for the lives of our mothers, the well-being of our community, and the future of generations to come.
This is more than just a conversation—it's a call to action. Every like, every share, and every comment helps build the momentum needed to push for lasting change in the healthcare system, ensuring that every Black woman receives the care, respect, and dignity she deserves. Together, we can make a difference. Our mothers, our community, and our future depend on it. Let's not wait—act now.
Keep up-to-date by connecting with the NBWN on X (formerly Twitter), LinkedIn, Facebook and Instagram and don't forget to use the #YouBelongHere
Sources:
MBRRACE-UK Report on Maternal Mortality
Barking, Havering, and Redbridge NHS Trust Stillbirth Negligence Data
NHS Equity and Equality Guidance
Five X More research on Black maternal health
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