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Experts ‘not surprised’ by England’s stark maternal health disparities

Black women have historically faced racism and mistreatment at the hands of medical professionals, campaigners have said

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Experts have said they are not surprised by England’s “stark” maternal health disparities after a new report has shed light on the reality many Black mothers across the nation are facing.

An analysis conducted by the Guardian found that Black women are up to six times more likely to experience some of the most serious birth complications during hospital delivery across England than their white counterparts.

Black women made up 26 per cent of the women who experienced the birth complication preeclampsia superimposed on chronic hypertension during delivery, the report showed, despite making up just five per cent of all deliveries across England.

However, the findings have come as no surprise to experts who said Black women and women of colour had historically faced racism and mistreatment at the hands of medical professionals.

“The Guardian’s analysis, which starkly highlights the severe disparities in birth complications amongst Black women, is deeply concerning, yet sadly predictable,” Agnes Agyepong, maternal health advocate and founder of Global Black Maternal Health, told Femtech World.

“Systemic and structural issues, such as disparities in healthcare access, quality of care, and exacerbated underlying chronic conditions due to socio-economic and environmental factors, play a significant role. These barriers mean that when Black women voice their concerns early on, they are often not heard, leading to delayed or less effective antenatal care and poorer outcomes.”

Without tackling these structural inequities, and without taking a biopsychosocial approach to maternity care, any long-term structural change remains a distant hope, Agyepong said.

Emily Butterworth, lead midwife at Lansinoh, said the “unfortunate reality” is that across England women’s ethnic background and socioeconomic status are strongly related to their likelihood of experiencing birth complications.

“To make pregnancy and birth safer we need a multifaceted approach, not only by midwives and obstetricians but also by public health professionals and politicians,” she explained.

“It is vital that we are raising awareness and training not only midwives and maternity professionals, but any health professionals who are caring for women before pregnancy and after pregnancy on cultural competency, and looking at ways we can eliminate implicit bias racial stereotyping.”

As part of efforts to reduce birth complications for minority groups and improve maternity care for all, Butterworth said we must address the roles of racism and discrimination in healthcare.

“Making birth safer for all will only be realistically achieved if we address the disparities in maternal health across the spectra of socio-economic backgrounds,” she said.

Black women in the UK are almost four times more likely to die in pregnancy and childbirth than their white counterparts, while black babies are twice as likely to be stillborn.

Emma Jarvis, founder and CEO of pregnancy subscription service Dearbump, said this is due to the fact that Black women are less likely to seek support and less likely to be offered treatment.

“If you are treated poorly and your pain is not taken seriously you lose faith and trust in the system, and it’s hard to break that cycle.

“There needs to be a conscious effort from healthcare providers, policy makers and women’s health organisations, to proactively engage with and check in with Black mothers, and to be aware of any unconscious biases that might exist and recognise the heightened risk they face in maternal outcomes.”

Empowering Black and Brown women in healthcare settings should be a priority, said Wendy Powell, founder and CEO of maternal pelvic health platform MUTU System.

“Black and Brown women experience disproportionate adverse birth outcomes due to ingrained prejudices dictating their treatment and care levels,” Powell told Femtech World.

“However, it’s crucial to recognise the presence of implicit biases and systemic racism within healthcare systems and create environments where Black and Brown women’s voices are heard.

“By challenging bias and advocating for change, we can amplify the voices of marginalised communities and work towards a healthcare system that serves everyone.”

Dr Ranee Thakar, president of the Royal College of Obstetricians and Gynaecologists, called on the government to set a definitive target to eliminate racial disparities in maternal deaths.

“Whilst the college continues to deliver quality improvement programmes in maternity, it is crucial that the government commits to sufficient, long-term NHS investment for staff recruitment, retention and training, which underpins safe and compassionate care,” she said.

“We are also calling for the government to commit to a funded, time-limited target to end the higher risk of maternal mortality among Black, Asian and ethnic minority women, and for women living in more deprived area.”

Bliss, the UK’s charity for babies born premature or sick, called for more research into maternal morbidity and preterm birth.

“We know that the higher rates of birth complications for Black and Asian women are likely to be just one of the reasons they experience higher rates of preterm birth and are therefore more likely to have a baby admitted to neonatal care,” Caroline Lee-Davey, chief executive of Bliss, said.

“This is an unacceptable disparity, yet we still know so little about the reasons underlying these serious inequities in care. Bliss would like to see more research funded which specifically looks at these issues to inform improvements in care for both pregnant women and new-born babies from the Black and Asian community.

“We also urge health services and professional bodies to ensure that all maternity and neonatal health professionals have access to training and guidance that will specifically enable them to support Black and Asian parents and their babies, to stop them being unfairly and avoidably disadvantaged by current practice, and to ensure every baby has the best chance of survival and quality of life.”

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Fertility

GLP-1 drugs do not increase pregnancy risks, study finds

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GLP-1 drugs taken before conception were not linked to higher pregnancy risks in new research, which suggested they may even offer some protection.

Women of reproductive age are increasingly prescribed GLP-1 drugs for weight-management support, but the risks and benefits of using them before pregnancy remain poorly understood.

The findings support continuing the use of GLP-1 medicines in women with metabolic risk factors who are considering pregnancy, said Cara Dolin, a maternal-fetal medicine specialist and co-author of the research, which was presented at the Society of Maternal-Fetal Medicine pregnancy meeting in February 2026.

“While there’s more research to be done, this data provides some reassurance that it is not harmful to be taking a GLP-1 if you’re planning a pregnancy, and that having done so may in fact benefit you by optimising your preconception metabolic health.”

The researchers examined electronic medical records for patients with a pre-pregnancy BMI of more than 30 who delivered at more than 20 weeks’ gestation. The data were reviewed for two studies: one assessed the link between pre-pregnancy GLP-1 use and the risk of gestational diabetes, while the second looked at the risk of severe maternal morbidity in patients with obesity.

Women with obesity, diabetes, cardiovascular disease and other cardiometabolic disorders have a higher risk of pregnancy complications including preeclampsia, gestational diabetes, stillbirth, caesarean section and other outcomes. While GLP-1 medicines can help manage these conditions, they are contraindicated during pregnancy, and women are typically advised to stop the medication two months before trying to conceive.

However, stopping the drugs can often lead to rebound weight gain or worsening metabolic health. A 2025 study suggested this rebound worsened some pregnancy outcomes, but the risks and benefits are still poorly understood, Dolin said.

“There is a lot we just don’t know, which is why we wanted to look at our experience here with our Cleveland Clinic patients and see whether taking GLP-1 drugs before pregnancy was causing harm or if it was beneficial and helping patients have healthier pregnancies.”

Researchers analysed data for more than 8,000 women who had obesity but did not have diabetes before they became pregnant. They compared outcomes for 208 women who had been prescribed GLP-1 receptor agonists before pregnancy with those who had not been prescribed the medication.

Women in the GLP-1 group had more risk factors heading into pregnancy. They tended to be older and have a higher body mass index, higher rates of bariatric surgery and chronic high blood pressure, and present earlier for prenatal care.

However, outcomes for the two groups were similar. Researchers found that the GLP-1 group did not have higher rates of gestational diabetes, severe maternal morbidity or other adverse maternal outcomes, suggesting that the medication may have helped mitigate elevated risk factors.

“I think this is a really important signal, and it may reflect that these patients were able to optimise their metabolic health prior to conception.”

“It shows there’s potential to use these drugs in a more targeted way with patients who are planning a pregnancy and have these different comorbidities and obesity.”

While the findings suggest that using GLP-1 drugs before pregnancy may be beneficial in women with metabolic risk factors, having a plan to stop the medicines before conception is essential, Dolin noted. In some cases, patients may be moved to an alternative medication that is safe for pregnancy and can be used to help manage their metabolic health during pregnancy.

Providers with patients who are taking GLP-1 medicines and planning a pregnancy should consider referral to a maternal-fetal medicine specialist for pre-pregnancy counselling.

“We can have a nuanced conversation with the patient about taking the medication, what the benefits are, what the potential risks are, and help them formulate a plan to transition off the medication once they’re ready to start trying to conceive,” she said.

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Cancer

New scan could speed up endometriosis diagnosis

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Obesity may be a key driver of rising rates of 11 cancers in adults under 50, a study has found.

The 11 cancers were thyroid, multiple myeloma, liver, kidney, gallbladder, colorectal, pancreatic, endometrial, oral, breast and ovarian cancers.

All except oral cancer are known to be linked to excess weight, with researchers saying raised insulin levels and inflammation may play a part.

The findings come from researchers at the Institute of Cancer Research, London and Imperial College London, who analysed national cancer registry data for England from 2001 to 2019.

In England, around 31,000 cancers were diagnosed in people aged 20 to 49 in 2023, equal to roughly one in every 1,000 people. This compares with 244,000 cases in the 50 to 79 age group, where the rate is around one in 100.

Concerns have been growing in recent years over rising rates of cancers such as bowel and ovarian in younger adults.

Among the younger group, breast cancer was the most common, with 8,500 cases, followed by bowel cancer at 3,000 and melanoma skin cancer with 2,800 diagnoses.

For nine of the 11 cancers identified, rates are rising in younger adults but also increasing in older adults, who are much more likely to develop the disease. Bowel and ovarian cancer were the exceptions, rising only in younger age groups.

The researchers found that bowel cancer rates in younger women linked to BMI rose faster, from 0.9 to 1.6 per 100,000 people, than those not linked to BMI, which rose from 6.4 to 9.6 per 100,000 people. Similar patterns were recorded for men.

However, the authors noted that the overall number of cases of BMI-linked bowel cancer in younger women remained lower than those not linked to BMI, suggesting other factors must be contributing to the increase.

Several suspected contributors, including ultra-processed foods, antibiotic use and air pollution, have been proposed in recent years. However, many of these factors have also shown stable or declining trends in the UK, the team said.

Despite the rise in several cancer rates among younger adults over the past two decades, most established risk factors, including smoking, alcohol consumption, red or processed meat intake, low fibre diets and lack of exercise, remained stable or even declined in the period leading up to diagnosis.

This suggests these traditional risk factors are unlikely to account for much of the increase in cancer cases.

By contrast, overweight and obesity, which have increased steadily since 1995, could be key factors in the rise in cases. The team suggested that between 2001 and 2019, around 20 per cent of the increase in bowel cancer was explained by increases in BMI over that period.

However, the researchers said rises in BMI alone are not enough to explain the overall increase in cancer among younger adults in England and that there are likely to be other causes.

Data also suggest around 15 per cent of bowel cancer in younger people could be linked to being overweight or obese, with around 40 to 50 per cent in total linked to the combined effect of known risk factors such as obesity, lack of exercise, alcohol and smoking.

Montse García-Closas, professor at the ICR, said more research was needed, but “we cannot wait to act”.

She told a media briefing: “Our main conclusion is that although BMI is our best clue, much of the increase still remains unexplained, and we’ve done some additional analysis that show that most likely what’s missing is not just a single cause unexplained, but it’s likely a combination of multiple factors that act together.”

Amy Berrington, professor at the ICR, said: “Although rates have been increasing, cancer in young people is still a rare disease.”

Marc Gunter, professor at Imperial, said obesity was a known risk factor for around 19 different cancers.

He added: “For some of these cancers, including colorectal (bowel) cancer, we think this could be partly caused by higher levels of hormones such as insulin, which is often elevated in people with obesity, as well as inflammation.

“We know people with obesity have higher levels of insulin, and insulin is a growth factor and has been linked to cancer.

“In a recent study, we actually found that insulin in particular might be playing a role in early onset colorectal (bowel) cancer, and this is actually an area of very active research at the moment.”

The researchers called for large, long-term studies to identify all the biological and environmental factors that could explain rising cancer rates in young adults.

García-Closas added: “Tackling obesity across all ages, particularly in children and young people, through stronger public health policies and wider access to effective interventions, could slow the rise in cancer and prevent many cancers and must become a national priority.”

Michelle Mitchell, Cancer Research UK’s chief executive, said: “Globally, and in the UK, we’re seeing a small increase in cancer rates in adults under 50.

“The picture is complex and we need more research to understand what’s driving the trend, but this study helps to fill in some gaps.

“Overweight and obesity doesn’t explain the rise in full though. Improvements in detection are likely to also be playing a part, meaning that more people are being diagnosed at a younger age.

“Preventing cancer cases must be a priority for the UK government. Smoking remains a leading cause of cancer in adults under 50, which is why the Tobacco and Vapes Bill receiving royal assent this week is such a historic moment.

“Measures to restrict the advertising and promotion of junk food, introducing mandatory reporting and targets on healthy food sales, and making nutritious food more accessible to everyone would all help people keep a healthy weight.”

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Diagnosis

WHO launches AI tool for reproductive health information

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The World Health Organization (WHO) has launched an AI tool in beta to help policymakers, experts and healthcare professionals access sexual and reproductive health information faster.

Called ChatHRP, the tool was created by WHO’s Human Reproduction Programme and draws only on verified research and guidance collected by HRP and WHO.

It uses natural language processing and retrieval-augmented generation to produce referenced content and cut the time spent searching through documents across different platforms and databases.

WHO said ChatHRP also has multilingual capabilities and low-bandwidth functionality to support use in a wide range of settings.

The beta-testing phase is aimed at a broad professional audience, including policymakers, healthcare workers, researchers and civil society groups.

WHO said the tool can help users quickly access up-to-date evidence, find sources for academic work and verify information on sexual and reproductive health and rights.

Examples of questions it can answer include the latest violence against women data in Oceania for women aged 15 to 49, recommendations on managing diabetes during pregnancy, and whether PrEP and contraception can be used at the same time. PrEP is medicine used to reduce the risk of getting HIV.

WHO added that the system will be updated regularly as new HRP materials are published and includes a feedback loop so users can flag gaps in the information provided.

The launch comes amid wider concern about misinformation in sexual and reproductive health.

A 2025 scoping review found that misinformation in digital spaces is a systemic issue that can undermine human rights, reinforce discriminatory social norms and exclude marginalised voices.

The review also said misinformation can affect health systems by shaping provider knowledge and practice, disrupting service delivery and creating barriers to equitable care.

WHO said ChatHRP is intended to give users streamlined access to reliable information as a counter to “algorithms, opinions, or misinformation”.

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