Black Maternal Health Awareness Week 2022

David Linden Excerpts

Wednesday 2nd November 2022 Westminster Hall

[David Linden (Glasgow East) (SNP)]

On a point of order, Mr Gray. I do not want to take too long on my point of order, but I thought it would be helpful for the Chamber to note the fact that it is Wednesday morning and that we are delighted to be here for this debate secured by the hon. Member for Streatham (Bell Ribeiro-Addy). I suspect that the hon. Lady will have quite a lot to say over the course of the morning, and I am just keen to ensure that we are all ready to take part in the debate.

[James Gray (in the Chair)]

That is very gracious of the hon. Gentleman. It is not actually a point of order. None the less, I am grateful to him for saying it. I think the hon. Member for Streatham has nearly caught her breath, in which case I would like to call her to speak.

--- Later in debate ---

[Bell Ribeiro-Addy]

I thank the hon. Member for his intervention, and he is absolutely right. I will come to training soon enough, and to what I believe individual trusts should be doing.

In addition to the Five X More report, Birthrights has recently published the findings of its inquiry into racial injustice and human rights in maternity care. The report uncovers the stories behind the statistics and demonstrates that it is racism—not broken bodies, as we are often told—that is the root of many of the inequalities of maternity outcomes and experiences. The study found that on a number of occasions, black women’s safety was put at risk while they were receiving care. They were ignored or their pain was dismissed, and they experienced direct or indirect racism from care givers. They were subject to dehumanisation. Their right to informed consent was violated and they faced structural barriers to receiving healthcare. Those women were going through one of the most painful experiences of their lives—one that can leave them at their most vulnerable—yet they faced institutional racism that impacted their health and the health of their babies.

During a debate on this subject last year, I called on the Government to launch an inquiry into institutional racism and racial bias in the NHS, as well as in the field of medical education. I reiterate that call today and hope the Minister will address the issue of systemic racism in medical care.

In addition to those two reports, the Muslim Women’s Network recently published a study that reviewed the experiences of Muslim women in maternity care. The report encompasses the maternity experiences of over 1,000 Muslim women, and it once again revealed that a huge proportion of respondents received poor or very poor quality care. There are many examples of substandard care by health professionals, such as dismissing concerns and, again, pain; not offering treatment to relieve symptoms; inconsistency in the way that foetal growth was measured; substandard clinical knowledge; and vital signs being missed, which contributed to poor healthcare.

Some 57% of women felt that they were not treated with respect and dignity in the way they were spoken to or in other acts of care giving, but perhaps the most shocking finding of the report was that 1% of the women who responded reported that their baby had died before or during labour, or within 28 days of birth. In a sample of this size, that equates to 10 women, which is way higher than the three to four who should have been expected.

Those statistics are shocking, but the stories are even more shocking. Each of those reports includes harrowing stories of women being neglected, and of their pain being ignored and their concerns dismissed, resulting in a near miss or, indeed, the loss of their baby. In one account, a woman was not believed when she informed the midwife that she was ready to push. It states that when she eventually began to push,

“Her baby came out still enveloped in the placenta. Several doctors came and she was taken to theatre as it became an emergency situation. It was touch and go but she survived. Due to heavy blood loss she was in a coma for three days. Her baby had to be given intensive care.”

In another account, a woman reports that her baby was struggling to breathe after birth. She says:

“I was told that it was a normal thing for newborns. No checks were done to put my mind at ease. After about 20 mins, my baby stopped breathing. Efforts were made to resuscitate her, but she later died in NICU.”

One woman recalled that during her first check-up, a nurse said that she was shocked that she knew who the father of her baby was because people like her do not usually know.

There are thousands of similar stories of black, Asian and minority ethnic women having negative experiences with healthcare professionals and maternity care. There is an urgent need to address the crisis in maternity care, and I sincerely hope that the Minister will set out concrete steps that her Department and the Government will take to address the problem.

I sincerely hope those measures will look beyond treating black, Asian and minority ethnic women as a problem. We are not the problem and our bodies are not broken. There is no flaw in our genetics and we do not need to be dealt with in a way that reduces negative statistics by just pushing the problem away. The suggestion that black women should be induced earlier because a lot of these issues present after 40 weeks is ridiculous.

The solutions need to address the distinct problems in maternity care; all the evidence suggests institutional racism. We must address biases and assumptions about black women, train medical staff to recognise common symptoms in black women, and tackle the barriers that prevent black women from receiving the quality of maternity care they deserve. That is where the problems lie, and we will overcome them by directly addressing racial disparities.

Last year when we debated this subject, the responding Minister asked me and others to continue to hold her feet to the fire on this issue. I thought they were really receptive and that we were finally going to see some meaningful steps to tackle maternal health disparities. I left the debate feeling slightly hopeful because so much awareness had been raised by the fantastic campaign groups I mentioned earlier, and there was a lot of support across the House. I was therefore really surprised and quite deflated when the next day the Minister moved Departments in a reshuffle. I know Cabinet reshuffles happen all the time—

[David Linden]

All the time.

[Bell Ribeiro-Addy]

They are a standard part of government, but we have lost count of the Health Secretaries and Ministers covering this brief. Today, we have a Minister from a different Department addressing us. I know it may seem like I am making a party political point, but regardless of reshuffles, Government priorities and resignations, the problems in maternity care continue. Although we cannot have continuity in Government for whatever reason, we need continuity in care and a strategy for dealing with racial disparities in maternity care.

It is hard to see the Government taking action when things are changing so frequently, but I sincerely hope the Minister will assure us that the Government are focused on this issue, regardless of the changes, and that her time in this role will be spent tackling black maternal health disparities.

Black women cannot afford to wait any longer for action to be taken. I do not want to have to stand up in another debate and cite exactly the same statistics without any improvement. I know things take time, but it would be sensational to come back next year and report that at least something had changed. The best way for Ministers to exact that change is to set out clearly what the Government are doing and set a clear target.

The answer I have been given in the past when I have asked for a target is that this does not happen to that many women, so a target does not need to be set. I would flip that round: if it is not that many women, surely we can set a target to address it.

--- Later in debate ---

[David Linden (Glasgow East) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Gray. I, too, congratulate the hon. Member for Streatham (Bell Ribeiro-Addy) on securing the debate and on opening it so well.

I was not due to speak in this debate on behalf of the Scottish National party; it was supposed to be my constituency neighbour and hon. Friend the Member for Glasgow North East (Anne McLaughlin), who has sadly been incapacitated and remains in Glasgow. I hope that those present will bear with me.

I speak primarily from my position as chair of the all-party parliamentary group on premature and sick babies, because our APPG has looked into the issue of racial disparities in maternal healthcare, as well as inequalities more generally in maternal healthcare and neonatal services. These topics merit more attention from the Government. As hon. Members have said, there have been numerous debates, questions, early-day motions and all those kinds of things on this topic. The benchmark for whether the Government are getting this right is whether we will be back in this Chamber in 10 or 15 years’ time to have the same conversation. I certainly hope we will not.

The Birthrights report, “Systemic racism, not broken bodies”, outlines the systematic racism in maternity services. That report confirms the devastating fact that black, Asian and mixed-ethnicity women are more likely to experience baby loss and illness, or to become seriously ill, and have worse experiences of care during pregnancy and throughout childbirth. I want to advocate for the report’s conclusion, which calls for a commitment to anti-racism by all maternity and neonatal services, and a commitment to ensuring that there are more black and brown women and birthing people decision makers in the wider maternity system. We have to look at the ticking time bomb in the neonatal and maternity workforce; that absolutely has to be in the mix. The report also calls for a safe and inclusive maternity and birthing experience for all parents, which I think we would all want to get behind.

Healthcare is devolved in Scotland, which is largely why I do not want to impose too much in this debate. However, the SNP Scottish Government believe that there needs to be an open and honest conversation about race and institutional racism right across these islands—Scotland is not immune—in order to identify solutions that will lead to equality and positive outcomes for black and minority ethnic communities. Members have asked a number of questions of the Government; for the sake of brevity, and so as not to repeat what has been said, I will just say that I would like to hear the Minister respond to those, particularly the seven points made by the hon. Member for Putney (Fleur Anderson).

I am very grateful to the hon. Member for Streatham for securing this debate and giving us an opportunity to focus on this issue. Most importantly, I am looking forward to hearing what the Government have to say, and to seeing what best practice can be rolled out in Scotland, because no part of these islands have a monopoly of wisdom or ideas.