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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
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.”
Xella Health has integrated Oura wearable data into its women’s health platform, allowing members to share trends with clinicians alongside diagnostic results.
Members can choose to share information including sleep, heart rate variability, resting heart rate, temperature trends, recovery, activity and menstrual-cycle data.
The integration is intended to help clinicians investigate biological factors that may explain changes in members’ wearable data and symptoms.
Kelly Lacob, chief executive and co-founder of Xella Health, said: “Wearables detect that something in the body has changed, but wearable data alone can’t tell a woman why or what to do next with that information.”
“By pairing continuous physiological monitoring from Oura with Xella’s multiomic diagnostics and physician-guided care, we enable women to understand how specific health concerns are impacting her biometrics, and vice versa how her daily habits are impacting her overall health and specific conditions or life stages she is navigating.
“Further, we are able to track how her relevant vitals and biometrics respond to specific interventions or treatment plans, so we can optimise her care more efficiently.
“Ultimately, this partnership helps us better address her symptoms today whilst also proactively optimising her long-term health trajectory for decades to come.”
Xella Health combines AI, multiomic testing and physician-guided telehealth care through a membership platform.
Multiomic testing analyses several types of biological information.
Xella said its testing assesses hormonal and metabolic health, inflammation, nutritional status, reproductive health and cardiometabolic risk.
Physicians use those findings to develop personalised care plans that may include clinical treatments.
Clinicians can then review shared Oura trends alongside diagnostic results and member check-ins to monitor progress and adjust care over time.
The company said providers interpret biometric data in the context of each member’s health conditions, goals and treatment plan.
The integration focuses on fertility, perimenopause, hormonal and cardiometabolic health, as well as women’s longer-term health.
Oura has expanded its women’s health offerings through integrations connecting wearable measurements with other sources of health data.
In February, it partnered with at-home hormone tracking company Mira, allowing users to view hormone test results alongside sleep, temperature and readiness data in the Mira app.
The integration is intended to help users track patterns related to fertility, menstrual cycles and perimenopause.
That month, Oura also introduced a women’s health AI model for testing through Oura Labs.
Integrated into Oura Advisor, the model combines biometric data with clinician-reviewed medical information to provide guidance on menstrual cycles, pregnancy and menopause.
In May, the company launched menopause insights and hormonal birth control support.
Its Menopause Insights offering uses a questionnaire covering 22 symptoms of menopause alongside wearable data, while birth control support helps users understand their biometric trends in the context of hormonal contraception.
Partners of women going through menopause will be invited to experience hot flushes using a menopause simulator at a support event in Hull next month.
Health group Over The Bloody Moon will bring one of its MenoVests to the Menopaus’ull Support Network event, allowing people to experience a hot flush.
Sarah Weichardt, who co-manages the project, said: “We’re particularly interested in getting men along to come and experience the MenoVest, just so that they can understand what women go through.
“It’s not just a hot flush, it’s what the hot flush brings with it.
“So it could be panic, it could be anxiety. It’s experiencing it all at the same time.”
MenoVest is billed as the ‘world’s first’ wearable menopause simulator – a garment worn over regular clothing that generates realistic, intense hot flush sensations while the wearer carries on with everyday work tasks.
After just a few minutes wearing it, people gain a genuine sense of what these symptoms feel like, building empathy and highlighting why better support matters during this transition.
Weichardt said she hoped the vest would give people a “better understanding of what women are going through”.
“The more people we can get to experience it, the better,” she added.
Short-term oral HRT was linked to a 60 per cent higher rate of serious blood clots in women aged 50 to 69, a large study found.
The increased rate was seen among women using oral hormone replacement therapy for less than a year as well as those treated for more than five years.
By contrast, transdermal HRT, delivered through skin patches, gels or sprays, was not associated with the same increased clot risk.
Researchers at North Zealand Hospital in Denmark analysed health registry data from more than one million Danish women aged 50 to 69 between 2003 and 2021.
During the study period, 9,807 women experienced venous thromboembolism, a serious blood clot in a vein. A further 18,460 had a stroke and 11,974 had a heart attack.
Each affected woman was matched by age with five women who had not experienced the same condition. Researchers adjusted the analysis for other factors, including medical history, that could influence risk.
They then examined HRT prescriptions, including the dose and duration of treatment, and looked for associations with blood clots, stroke and heart attack.
Overall, oral HRT was associated with a 60 per cent higher rate of venous thromboembolism, with increased rates seen for both oestrogen-only therapy and treatment combining oestrogen with progestogen.
Venous thromboembolism occurs when a blood clot forms in a vein. A clot in a deep vein can break away and travel to the lungs, causing a potentially fatal pulmonary embolism.
Women taking oral HRT for less than a year had the same raised blood clot risk as those using it for more than five years.
Even a daily oral dose below 1mg was found to significantly increase blood clot risk.
Women taking a daily oral dose above 1mg for more than five years had an 80 per cent higher risk of both heart attack and stroke.
For women taking a high oral dose for more than one year, the study found a 40 per cent higher risk of heart attack and a 50 per cent higher risk of stroke.
The researchers highlighted the importance of choosing the type, dose and duration of treatment carefully, particularly for patients vulnerable to blood clots.
Dr Robert Storey, professor of cardiology at the University of Sheffield, who was not involved in the research, said the findings demonstrated the importance of ensuring cardiovascular risk factors were “well controlled” in women taking oral HRT.
He added: “The study emphasises the superior safety of patches over oral treatment.”
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