Black Maternal Healthcare and Mortality

Helen Hayes Excerpts

Monday 19th April 2021 Westminster Hall

[Helen Hayes (Dulwich and West Norwood) (Lab) [V]]

It is a pleasure to serve under your chairmanship, Sir Gary. I pay tribute to Tinuke and Clo for their vital work campaigning on black maternal health under the banner Five X More . I also pay tribute to my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for sharing her devastating experience so bravely and powerfully.

The statistics on maternal mortality are truly shocking. Skin colour should have no correlation with maternal health, yet in the UK, black women are over four times more likely than white women to die during pregnancy or childbirth; women of mixed heritage are three times more likely; and Asian women are twice as likely. What is even more shocking is that the gap has been widening—not for a short period of time, but for more than a decade.

The factors contributing to maternal mortality rates are complex and multiple. Social and economic factors have a strong influence on underlying health. Pressures such as insecure work, low income and fear of losing employment force some women into unsafe situations. Implicit racial bias in healthcare can lead to assumptions being made and some women not being listened to. The extent to which women are listened to, respected and empowered throughout pregnancy and childbirth has a vital bearing on ultimate outcomes.

The most shocking aspect is that every organisation concerned with maternal mortality says that more research is needed to understand why black women are at greater risk of death. After a decade of increasing black maternal health disparity, we still need more action to understand why there is such appalling racial healthcare inequality, so that action can be taken to stop it. That means better data collection, clear and measurable targets, and more funding for research.

We have to ask why those appalling statistics have been of so little concern to the Government that they have failed to undertake any major inquiry or fund significant research. There is a gender and ethnicity gap in medical research, and that must change. The Government must now commission an independent review of the ethnic disparity in maternal mortality, looking in detail at the data and capturing the lived experience of black women, Asian women and women of mixed heritage.

I want to highlight in particular some of the things that are known and on which action could be taken right away to make a difference, even as further research is commissioned. We know that women from black and Asian backgrounds are more likely to be key workers in frontline roles and physical roles such as social care. Many of those women are on low pay and in insecure work. Maternity rights and health and safety protections at work must be extended to all women, whatever their employment status or job role. It must not be the case that fear of losing pay or losing work forces pregnant women to risk their health, either through the work itself or through being unable to attend essential healthcare appointments.

The barriers to accessing healthcare that face some black and Asian women, particularly asylum seekers and women with no recourse to public funds, must be removed. In maternity care, relationships really matter. Women’s experiences during pregnancy and childbirth are far too inconsistent across the country, but often, the best care is delivered by community-based midwifery teams, working across both community and hospital settings and enabling women to get to know and trust the midwives who will eventually deliver their babies. Dealing with a birth is not like other forms of healthcare. Women in childbirth should feel that they are equal partners with midwives, doctors and the wider professional team to deliver their baby safely.

Finally, the racial disparities in maternal health further serve to underline the nonsense of the report by the Commission on Race and Ethnic Disparities. That report straightforwardly denies the lived experience of many black people and people of colour living in the UK. Addressing structural racism, shown so clearly in the health data we have been discussing today, must start with listening to and taking seriously the experiences of black people and people of colour in the UK, not denying those experiences. That report will not even help to get off the blocks the work that needs to be done to iron out and remove racial disparities in maternal health.