An urgent inquiry to investigate how alleged systemic racism in the NHS manifests itself in maternity care will be launched on Tuesday with support from the UK charity Birthrights.
The inquiry will apply a human- rights lens to examine how claimed racial injustice – from explicit racism to bias – is leading to poorer health outcomes in maternity care for ethnic minority groups.
Data published last month by MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the country) showed black women were four times more likely than white women to die in pregnancy or childbirth in the UK while women from Asian ethnic backgrounds face twice the risk.
Barrister Shaheen Rahman QC, who will lead the inquiry, said: “In addition to these stark statistics there are concerns about higher rates of maternal illness, worse experiences of maternity care and the fact black and Asian pregnant women are far more likely to be admitted to hospital with Covid-19.
“We want to understand the stories behind the statistics, to examine how people can be discriminated against due to their race and to identify ways this inequity can be redressed.”
An expert panel that includes a human rights lawyer, a clinical negligence solicitor, doulas – trained healthcare companions – obstetricians and midwives will oversee the inquiry.
Rahman will be supported by two co-chairs, including Benash Nazmeen, director of the Association of South Asian Midwives. “As a midwife and an aunt to 13, I have witnessed, heard and felt the discrimination faced by south Asian communities,” she said.
“The repeated questions based on racial stereotypes, unsafe antenatal conversations due to cultural and communication barriers, and the appalling statistic that Pakistani women are more likely to have a premature baby or neonatal death in the UK compared to their country of origin – there are too many concerns that need to be unpicked and addressed.”
Research published in 2013 found that women from minority ethnic groups had a poorer experience of maternity services than white women. They were more likely to deliver by emergency caesarean section, less likely to have pain relief during labour and received fewer home visits from midwives. The rates of baby loss are also higher for these groups, according to findings by MBRRACE-UK.
Amy Gibbs, the Birthrights chief executive, said: “A lot of black and brown people in the birthing world are understandably frustrated by calls for more research when what’s needed is action. This inquiry will take the starting point that racism exists in our society so it must exist in the NHS.”
Gibbs added: “We know many healthcare workers provide safe, respectful care to everyone, regardless of their ethnicity. But the evidence shows persistent inequities in maternity outcomes and experiences. We want to understand how racial bias and systemic racism impact on people’s basic rights in pregnancy and childbirth, so we can be honest about the harms being caused and what needs to change.
The inquiry is particularly urgent in light of how existing inequalities have been exacerbated by Covid-19.” Black pregnant women are eight times more likely and Asian women four times more likely to be admitted to hospital with Covid-19 than white women.
A new role of head of midwifery research has been created by NHS England to focus on health inequalities associated with maternity outcomes for mothers and babies from black, Asian and ethnic minority families. Prof Jacqueline Dunkley-Bent, the chief midwifery officer for England, said: “Research is just one of the tools we will be using to improve maternity care for these mums and their babies.”
She added: “Everyone working in maternity services wants all women to have the safest possible care, which is why as soon as evidence of heightened risks for pregnant women from black, Asian and ethnic minority backgrounds giving birth during the pandemic became clear, support for these women was boosted.”
An initiative where women from these ethnic groups are seen by the same midwife and team throughout their pregnancy, birth and postnatal period to ensure continuity of care is being fast-tracked by the NHS.
Case study: ‘The midwife was trying to gaslight me’
After going into labour with agonising contractions in March 2016, Sandra Igwe attended hospital and was sent home five times before finally being admitted. Previously, she had felt judged and experienced alleged racism during a pregnancy appointment, which led to a letter of apology from the hospital.
But she says she was shocked that during childbirth and while feeling at her most vulnerable she would again face such treatment. “They would not believe I was in active labour,” she explained. “The midwife said my cries of pain did not coincide with my contractions and they withheld an epidural for hours on end.
“The midwife was trying to gaslight me, it was horrific. They kept asking ‘why are you screaming?’ and said I was being ‘rude’.”
She says it was only when her baby’s heart rate dropped and she was sick that she was taken seriously.
The experience caused her to suffer postnatal depression which went undiagnosed. Feeling isolated after the birth of her daughter, she set up a social enterprise to amplify the voices of black mothers called the Motherhood Group which has gone on to support hundreds of women.
Igwe, who will co-chair the inquiry, said: “Racism in maternity care in the UK is insidious and because it is covert and subtle it’s hard to describe how you are feeling. The strong black woman streotype is killing us. We should be allowed to be vulnerable and scream in pain.”
She worries that too many mothers have postnatal depression which is going undiagnosed. “Black mothers do not trust the healthcare system and they are not seeking out support because when we do we are dismissed and ignored and the information we share is weaponised against us.”
Свежие комментарии