Our healthcare system is failing pregnant black women – government must take action
It is alarming that black women are four times more likely than white women to die in pregnancy and childbirth. We need a strategy to deal with this problem.
Most women never feel more vulnerable than when they are pregnant. It is partly because of the physical changes to your body. But it also the idea that you are now responsible for another life not just yourself. So the fact that black women are four times more likely than white women to die in pregnancy and childbirth is alarming.
What makes it worse is that the disparity is well known and the black maternal death rate has been climbing for years. Yet nothing seems to have been done about it by the Health Service. As one of the campaigners on this issue has said, “If white women were dying at these rates they would do something about it”. Furthermore, black babies are 121% more likely to be still born than white babies and have a 50% increased risk of dying immediately after birth.
Over and over again black women say they don’t feel listened to, their life was not valued, their pain was not taken seriously, and they were not given choices
The first question to ask is why is this happening? It would appear to be a constellation of biases. There seems to be the idea that black people have a higher tolerance for pain. So when black women or their partners try to raise the alarm about pain in childbirth they are not listened to. Consequently, there are too many examples of poor care, such as women in pain after childbirth only to find that there is placenta and blood clots still in their womb. Even if women do not actually die, a bad experience of childbirth can lead to chronic pain and numerous surgeries.
Over and over again black women say that they don’t feel listened to, their life was not valued, their pain was not taken seriously, and they were not given choices. Black women often don’t seem to be given the right information to make informed decisions about their pregnancy and childbirth.
It is a complex issue. Some of the factors may be about pre-existing medical conditions, access to ante-natal care, women in bad housing and poor socio-economic conditions. But campaigners agree that the NHS has not focussed properly on the issue. And, even when researchers have allowed for class, black and Asian women in general still have poorer experiences of childbirth than white women.
The problems in pregnancy and childbirth come on top of a number of gynaecological issues that black and Asian women face. The level of stillbirths amongst black women continue to rise. Black women are more likely to suffer from infertility and three times more likely to have fibroids.
The answer to the alarming death rate of black women in pregnancy and childbirth begins with recognising that this is a serious problem and the numbers of women dying cannot just be allowed to continue to rise. Then there needs to be more effort to collect accurate data. It can be too easy to generalise about black people. But there may be different issues for a third-generation Nigerian mother as opposed to a more recent migrant.
Almost as important as collecting accurate data is midwives and doctors actually listening to black women. Campaigners are working hard to encouraging black women to advocate for themselves. But the NHS needs to understand the importance of making sure women’s voices are heard, including black women. It is also important to have a diverse NHS workforce at all levels.
After all the years that the death rate for black women in pregnancy and childbirth has been rising, the NHS now needs to focus on a strategy to deal with this problem.
The government seems to think that there is no such thing as institutional racism. And it is reluctant to devise strategies focussed on black people. But black maternal healthcare is a striking example of a government institution, in the form of the NHS, failing pregnant black women year after year.
Government needs to listen to campaigners and set targets to bring down the level of these tragic deaths.
Diane Abbott is the Labour MP for Hackney North and Stoke Newington.
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