Black Maternal Health Awareness Week 2022

Debate between Jim Shannon and Bell Ribeiro-Addy

Wednesday 2nd November 2022 Westminster Hall

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

I beg to move,

That this House has considered Black maternal health awareness week.

Thank you very much, Mr Gray; it is a pleasure to serve under your chairmanship. I thank my colleagues for their kind points of order. I am thankful, as always, that this debate has been awarded, so that we can once again have this vital discussion about the issues surrounding black maternal health.

Whenever I discuss black maternal health, I always take time to repeat the statistics around black maternal mortality. The reason I do that is twofold. First, the statistics are harrowing, and it is only by confronting them that we can truly begin to address the issue. Secondly, the statistics have not changed at all—the findings that I repeat have not improved, despite this issue having been raised for a number of years. I know that it may take time before we see a real change in statistics, but the Government are yet to introduce any meaningful measures that give us confidence that the statistics will change any time soon. Most notably, they will not even look at producing a target.

I repeat it for everyone who may not have heard that black women are four times more likely to die in pregnancy or childbirth, women of mixed heritage are three times more likely to die in pregnancy or childbirth, and Asian women are twice as likely to die in pregnancy or childbirth. Black babies have a 121% increased risk of stillbirth and a 50% increased risk of neonatal death. Asian babies have a 55% increased risk of stillbirth and a 66% increased risk of neonatal mortality. Black women have a 43% higher risk of miscarriage, and black ethnicity is now regarded as a risk factor for miscarriage.

The last time we had this debate, one of the key themes that kept coming up was data, whether it was Members such as myself raising the fact that the data exists and research has been done—we just need the Government to engage with it—or the Minister who responded, the right hon. Member for Mid Bedfordshire (Ms Dorries), stating that black women are under-represented in the Government’s data. I am pleased to say to the Minister responding today that there is now even more research out there.

Since the last time we had this debate, Five X More has carried out and released the findings of its black maternal experiences survey. This is the largest survey of black women’s maternal experiences ever conducted in the UK. It gathered responses from over 1,300 women and looked at their experience of maternal care. The report highlights all the negative interactions that women experienced with healthcare professionals, from feeling discriminated against in their care to receiving a poor standard of care, which put their safety at risk, and being denied pain relief because of the ridiculous trope that black women are less likely to feel pain.

The report goes on to reveal how the discriminatory behaviour and attitudes that black, Asian and ethnic minority women face have been shown negatively to impact women’s clinical outcomes and their experiences of care. More than half the respondents reported facing those challenges with healthcare professionals during maternity care, and 43% of women reported feeling discriminated against, while 42% of women reported feeling that the standard of care they received during childbirth was poor or very poor, and 36% reported feeling dissatisfied with how their concerns during labour were addressed by professionals.

Further to that, 42% of respondents reported feeling that their safety had been put at risk by professionals during labour or during the recovery period. Of the women who experienced negative maternity outcomes, 61% reported that they were not even offered additional support to deal with the outcome of their pregnancy.

[Jim Shannon]

I am pleased that the hon. Lady has brought this debate to Westminster Hall, and although there might not be big numbers here today to discuss the matter, it is of great importance. Does she not agree that health trusts, which she has referred to, must ensure that no matter the level of the black, Asian and minority ethnic population, staff are adequately trained to deal with the differences with respect to different ethnic groups? Does she further agree that the messaging that comes from the Minister and the Department in this debate is the most important tool that health trusts have to ensure that women of all ages and all ethnic groups are clearly understood and supported, no matter where they are and no matter what the statistics and numbers may be?

[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—

Covid-19: Small Businesses in Streatham

Debate between Jim Shannon and Bell Ribeiro-Addy

Tuesday 18th January 2022 Westminster Hall

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

I beg to move,

That this House has considered support for small businesses in Streatham during the covid-19 outbreak.

It is a pleasure to serve under your chairpersonship, Ms McVey. I am glad to be introducing this debate on a vital issue in my constituency—an area that includes Brixton Hill, Clapham Common and Tulse Hill.

As we all know, small businesses are the backbone of our local economy, culture and community, and I recognise the enormous contribution that small and medium-sized enterprises make in Streatham and all over the UK. Whether it be corner shops and cafes that have had to work throughout the pandemic, or independent retailers and the self-employed who have been short-changed by the Government, they deserve support and recognition for the diverse range of services and support that they continue to provide to our communities. However, it is devastating that small businesses are likely to have seen their turnover plummet by more than half, and that freelance workers and the self-employed have been completely ignored by the Government and left with minimal financial support during the coronavirus pandemic. Almost 50 shops a day vanished from our UK high streets over the first six months of 2021, and Labour projections from October suggest that 263 businesses in Streatham alone are at risk of closure over the next three months. The situation is completely dire.

Members may know that Streatham was home to the UK’s first supermarket, and that Streatham High Road is the longest high street in Europe and home to a hub of creative and diverse small businesses, which is reflected through our thriving arts and culture scene. I always tell people that should an apocalypse come, my constituency is probably where they would want to be. We have the windmill at Brixton Hill, which was the last operational windmill in London; two operational beehives; and numerous community gardens, such as Railside gardens, Urban Growth and St Matthew’s gardens, which always produce the best in fruit and veg.

If vegan January has not quite hit, we also have London Smoke & Cure, which offers the very best in smoked and cured fish and meats. If the practicalities are not enough to convince people, we are also home to the Inkspot brewery, not to mention some of the finest craftspeople in the country. In Streatham, we grow, produce and sell locally. We also regularly host the Streatham Festival, the Streatham Food Festival and the Streatham Literature Festival, run by Jane Wroe-Wright and her tenacious team, and there has been an enthusiastic local campaign to reopen the historically listed Streatham Hill Theatre as a community arts hub.

Over the past two years, I have visited dozens of small businesses in Streatham to talk to owners and staff about the impact of the pandemic. Since the earliest phases of the pandemic, they have thrown themselves into the coronavirus response, fighting to keep their businesses open while demonstrating their sense of duty to the wider community. In Streatham, we saw independent coffee shops giving away free coffee to NHS workers, computer repair specialists offering to repair laptops at no cost, and local firms stepping up to laser-cut personal protective equipment to meet shortages in our care homes.

We have also seen some amazing and original initiatives get off the ground. Whether it is local people donating their used devices to disadvantaged school pupils, food banks managing to meet a 134% increase in demand or mutual aid groups springing up to help the community, we have seen people pull together and innovate. Time after time during this acute period of hardship, our small businesses have stepped up. However, the pandemic has meant that SMEs in my constituency and across the country have had to close their premises permanently due to the impact of declining footfall.

[Jim Shannon (Strangford) (DUP)]

I commend the hon. Lady for securing the debate. I asked a question on this issue in the Chamber some time ago. All too often, we have heard of businesses across the United Kingdom having to close for isolation periods as there are not enough staff to keep them open, as she said. Does she agree that consideration should be given to a scheme whereby businesses with fewer than five members of staff, which we are referring to, are eligible for some sort of financial assistance should they have to close due to staff isolation, such as if staff have been a close contact of a covid case?

[Bell Ribeiro-Addy]

The hon. Member is absolutely right. I will make that point later. We have to do everything we can to support our small businesses.

Examples of business closures in Streatham include acclaimed live music and hospitality venue the Hideaway, where I and others across the city have spent many a good night out. This has been a major loss for the area—an independent venue at the heart of the community that for many years has been growing local and international music and comedy. Due to the number of lockdowns, the slow response for those in the night-time economy, and social distancing requirements, its business model was untenable. We also saw the closure of Fal Patel’s local convenience shop in Clapham Park and E & A Wates furniture shop on Mitcham Lane, which once undertook restoration work for the parliamentary estate during its 120-year history.

Many start-ups that would have grown to become high street businesses were unable to access any grants due to not having a high street premises, which has impacted the long-term economic growth of the area as our cafés, co-working spaces and performance spaces, and the buoyancy of our local business hubs, rely on the small enterprises of the daytime economy.

These are only some of the publicised closures within the constituency. It is fair to say that the demise of small businesses is so vast that we all personally know of someone in our local community who has lost out on their business during the pandemic; maybe it was a local restaurant, an appliance shop, a corner shop, a pub, a bar, a butcher, a baker, a greengrocer, a hairdresser—the list goes on.

Sickle Cell Treatment

Debate between Jim Shannon and Bell Ribeiro-Addy

Wednesday 8th December 2021 Westminster Hall

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

It is a pleasure to serve under your chairship, Mrs Miller. I congratulate my right hon. Friend the Member for Wolverhampton South East (Mr McFadden) on securing this debate and on his sterling work as the chair of the sickle cell and thalassaemia all-party parliamentary group. I also commend my neighbour, my hon. Friend the Member for Vauxhall (Florence Eshalomi). She always speaks with such affection about her mother, and I hope that she knows that her mum would be so incredibly proud of her if she were alive today.

The APPG’s landmark report, which was triggered by the tragic and avoidable death of Evan Nathan Smith in North Middlesex hospital, reveals the terrible truth of sickle cell treatment: the substandard care, the stigmatisation and the lack of prioritisation of this condition. As an officer of the group, I was pleased not only that the report came out, but to be able to give evidence as somebody who cared for someone with sickle cell—as someone who lost a loved one, my friend Adjuah, to negligent care. I sat with her through many hospital admissions, and I witnessed mistakes and mistreatment. She said to me on more than one occasion, “One day this hospital is going to kill me,” and one day it actually did. I hope that the Minister has read the report, has taken into account its many recommendations and will outline what steps the Government will take to improve the treatment of sickle cell and the overall experience of sickle cell patients in our national health service.

I also hope that the Minister will touch on what steps the Government will take specifically to improve the treatment of black sickle cell patients. Unfortunately, for those of African and Caribbean heritage, the experience of sickle cell is made far worse by the prevalence of institutional racism. In several past debates and in various inquiries, reports and personal accounts, we have heard how racist attitudes have a negative impact on a patient’s healthcare and experience: lack of research, which is certainly a major issue with sickle cell; biased perceptions of pain tolerance, drug habits and medical knowledge; and experiences of overt racism. All of that makes the experience of living with any condition difficult, but it makes living with sickle cell even harder.

When we talk about institutional racism in the NHS, we are sometimes met with Conservative Members saying, “Why are you calling our NHS staff racist?”. We are not calling NHS staff racist; we value our NHS staff. We are recognising that the institution of the NHS, which is governed by the Government, has issues when it comes to race, and that the policies and practices create biases that cause us problems. We want to know what the Government are doing about that.

Sickle cell is often referred to as an invisible illness, because of how the pain is experienced—often it is invisible to others. However, there is also a distinct lack of education and public awareness of the condition and the symptoms. I point specifically to the issue of education. I studied biomedical sciences and specialised in cellular pathology as an undergraduate. Because of the amount I knew about sickle cell before I went to university, I was struck by just how much it was used as an example but just how little those teaching me knew about its practical aspects. If we do not improve the education of those who treat people, we are never going to improve the outcomes. That definitely needs to be looked at.

The recent removal of discriminatory blood donation restrictions on black donors was a massive step in the right direction, which I really welcome. The largest beneficiaries of the change will be those patients who are often treated through blood transfusions and need rare blood subgroups, such as Ro, that are more common in black people. I have that blood group, so I give blood. Blood donations have gone down rapidly during the pandemic, but they are needed no less at the moment. I encourage all people from the black community, and from all communities, to give blood. I would love to see a blood donation stand in Parliament one day; there are so many of us here, and we should all be able to roll up our sleeves and give a pint or two.

[Jim Shannon]

I think that the Government have been keen to have blood donations, and the hon. Lady has very kindly volunteered and has been donating. She could perhaps be a poster lady for the campaign. Maybe the Minister will take that on board.

[Bell Ribeiro-Addy]

I thank the hon. Gentleman for his contribution, and look forward to seeing him roll up his sleeve as well.

Maintaining those discriminatory blood donation rules for so long was really poor. They were based on outdated HIV science and denied thousands of black sickle cell patients the treatment that they needed, but not only that; the legacy of those rules resulted in a reluctance among the black community to come forward to donate blood. The restrictions have resulted in a shortage of black blood donors and have had a severe effect on the willingness of the black community to donate overall. We have to undo that damage.

I call on the Minister to promise all of us here, and those who are keenly watching the debate, that the Government will act to improve the quality of care and treatment of sickle cell patients. Words are good, but action is better. My hon. Friends have touched on prescriptions and the barriers to receiving proper care. We want action on that. Those watching the debate at home do so in eager anticipation of something that will give them hope of better treatment. I sincerely hope that the Minister will not let them down.

Black Maternal Health Week

Debate between Jim Shannon and Bell Ribeiro-Addy

Tuesday 14th September 2021 Westminster Hall

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

I beg to move,

That this House has considered Black Maternal Health Week.

It is a pleasure to serve under your chairmanship, Mr Hollobone. I am thankful that we are able to have this debate, which follows from an e-petition debate that was held in April after the petition received over 180,000 signatures. MPs were given the opportunity for the first time to debate a petition calling for improvements to maternal mortality rates and healthcare for black women in the UK.

I would also like to take this opportunity to thank Tinuke and Clo from Five X More, as well as Elsie Gayle, whose tireless campaigning efforts have forced this issue on to the agenda. They have not only provided us with the opportunity to discuss the issue but given a voice to many black women who have experienced a traumatic pregnancy or birth and to those families who have lost loved ones.

For too long the statistics had pointed towards a glaring disparity in black maternal health experiences, and for too long nothing was said. We now have a Black Maternal Health Awareness Week, during which we can highlight the disparities and discuss ways in which we can make pregnancy a safe experience for all, regardless of skin colour.

Members will by now be very familiar with the statistics surrounding black maternal healthcare and mortality, but they bear repeating. In the UK, which is one of the safest countries in the world in which to give birth, black women are still four times more likely to die in pregnancy or childbirth. Black women are up to 83% more likely to suffer a near miss during pregnancy. Black babies have a 121% increased risk of stillbirth and a 50% increased risk of neonatal death. Miscarriage rates are 40% higher in black women, and black ethnicity is regarded as a risk factor for miscarriage. Black mothers are twice as likely to give birth before 37 weeks of pregnancy.

The situation for women and birthing people of mixed heritage and Asian heritage, unfortunately, is not much better, with those of mixed heritage being three times more likely to die in pregnancy and childbirth, and Asian women two times more likely. Asian babies also have a 55% increased risk of stillbirth and a 66% increased risk of neonatal mortality.

However, we all know that racial disparities in health do not begin, and certainly do not end, there. Despite these statistics, despite the number of reports and studies that have been produced in the last year and before, and despite being aware of the glaring disparities in maternal healthcare, we still have no target to end them.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for giving way. The statistics are alarming and disconcerting. That black ladies are four times more likely to die in childbirth is shocking. Does she agree that the Government and the Minister now have a responsibility urgently to outline steps to address this? The hon. Lady has outlined the issue, but we want to see what the response will be to make it better.

[Bell Ribeiro-Addy]

The hon. Member is absolutely right. With disparities such as these and no clear way forward, that is what we are hoping to hear from the Government. With all the information that we have, it is clear that the response is not good enough.

In the USA, where there is also a glaring disparity in maternal health outcomes for black and ethnic minority women, the Government have actually begun to take steps to address the problem. In April, the White House issued its first ever proclamation on black maternal health. President Joe Biden declared a Black Maternal Health Week, to take place annually from 11 to 17 April.