Black Maternal Healthcare and Mortality

Bell Ribeiro-Addy Excerpts

Monday 19th April 2021 Westminster Hall

[Bell Ribeiro-Addy (Streatham) (Lab) [V]]

It is a pleasure to serve under your chairmanship, Sir Gary. I start by paying tribute to Tinuke and Clo from Five X More, who have been leading the charge in calling for action on black maternal health. Black women are four times more likely to die in pregnancy and childbirth—we have heard that many times today, and we will probably hear it some more, but I really want it to hit home. We know this, but we have no target to end it.

During my own pregnancy, it was not hard to find instances where, as a black woman, how I was perceived or believed drastically impacted the care I received, from complaints about how I was feeling to being denied scans. We know that black women are perceived to experience less pain. We know this, and we have no target to end it.

Things went from bad to worse for me. I was swollen. My blood pressure would get so high that I would feel dizzy and my nose would bleed. My doctor eventually had me rushed to the hospital for further tests and scans, and I was admitted to the hospital with pre-eclampsia. My last conversation with the consultants was harrowing. They said that my pregnancy had become very dangerous and there were only two outcomes: my child would die, or both myself and my child would die. My diagnosis was too late for any intervention, and simple steps—which I soon found were simple things such as taking aspirin—were no longer an option for me. The consultants’ advice was for a late termination and a delivery to save myself. They also explained that my condition was deteriorating so quickly that I would immediately have to nominate someone to make the decision for me if I should become unconscious.

Some 83% of women of African origin, like myself, and 80% of Caribbean women suffer a near miss in pregnancy and childbirth. Not only do we not have a target to end this, but we do not have information about the health issues that black women go on to face. I did not have to make this decision, because a scan scheduled the day after that meeting showed that my baby’s heart had stopped beating. I was induced, and after something like 18 hours of labour, she was born. As a person of faith, even then, I still had faith that maybe the doctors were wrong and everything would be okay, but she did not move, she did not cry, and there was no miracle. Black babies have a 50% increased risk of neonatal death, and a 121% increased risk of stillbirth, like my own daughter. With figures like that, I wonder how much of a chance she really had. We know this, and we have no target to end it.

When I talk about this, I am asked how long ago it was and how far along I was. I just want to say that when any woman loses a baby, however her pregnancy ends—miscarriage, stillbirth, or even an abortion if she had to have one—it is not for anyone else to quantify how much pain she must feel, as if to decide how much empathy to show, and it is certainly not for them to decide how much care she should be shown.

I would like people to stop blaming black women—that is all I have heard in response to some of the messages that have been put out. So often, black women are viewed as the problem, but we could be the solution if people would just listen to us, respect us and care for us. We are not a lump of comorbidities—some of us who go on to have these tragic experiences did not even have any comorbidities. We are black women who have decided to bring life into this world, and that choice has become a matter of life and death and health. The inequality we face is not our fault. Inequality is an institutional and political outcome—an institutional and political choice—and it is the duty of the Government to end it, not to outsource responsibility and blame those who are suffering.

In the US, they have just had a Black Maternal Health Week, and $200 million were put towards ending this disparity in training clinicians. In the UK, we have a Government who have ordered reports saying that institutional racism does not exist. So when the Minister responds today, I do not want to hear what the Government think is wrong with women who look like me; I want to hear what they will do to protect women who look like me, and the children we have. I want to hear that this Government realise that if they are not part of the solution, they are part of the problem, and I want them to acknowledge the institutional racism that we face and to have a target to end it. The colour of a woman’s skin should have no bearing on whether she or her child live or die.