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

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.”