This week (15-19 May 2023) is Black Baby Loss Awareness Week (BBLAW), which highlights the tragedy of baby loss and, in particular, the disproportionately high levels of black baby loss and neonatal deaths in the UK.
When having a baby, all women, regardless of ethnicity, should be entitled to receive safe healthcare. However, reports have found that maternal mortality for black women is currently almost four times higher than for white women.
Black and mixed black heritage women are also 43% more likely to have a miscarriage, and, shockingly, almost 50% more likely to experience stillbirth. Just as devastating is the fact that black babies are over twice as likely to be stillborn and almost twice as likely to die in the first 28 days after birth, when compared to white babies.
There have been several reports in recent years which highlight the significant disparity in maternal death, baby loss and neonatal death rates for black and Asian women when compared to white women, including the reports by MBRRACE-UK, the House of Commons Women and Equalities Committee, the Sands and Tommy’s Joint Policy Unit, and Donna Ockenden, to name a few. There is a call for further action to support these women and to lower the levels of mother and baby loss in the UK.
So far, not enough is being done to change the outcome for these individuals. Here, we consider the current position and the findings of these reports.
A report by MBRRACE-UK found that improvements in care may have made a positive difference to the outcome of 38% of the women who died between 2018-2020.
A review by Sands and Tommy’s, meanwhile, found that there are significant differences in access to and treatment by maternity services for women of black and Asian heritage. More needs to be done to identify the reasons for the disparity and to address this in the institutions providing care.
Women living in the poorest areas of the country, where a higher proportion of babies belonging to ethnic minorities are born, are two and a half times more likely to die than those from the wealthiest. This points to social and economic disparity being a significant factor for baby loss. Socioeconomic conditions are a well-known factor for health issues, but further research and policy changes are required to explore this further.
Women who have first-hand experience of this have stated that their ethnicity is often a direct factor in the care they are given – Tinuke Awe, speaking to the BBC, said: “There is a stereotype of black women not feeling pain and being quite aggressive and loud, very strong, so we're able to take more pain.” MBRRACE-UK found that black and ethnic minority women are less likely to be given different forms of pain relief. The reason for this is unclear but it does suggest that these women may not be being heard when discussing their childbirth plans and concerns.
The MBRRACE-UK report also notes that a shortage of staff in maternity care is the biggest concern for the quality of maternity care, but that does not explain why black and mixed heritage women should be at a disadvantage to white women.
There are no national targets or long-term funding specifically in place to reduce inequalities between ethnic groups or areas of deprivation. We still need to understand how racism, bias and discrimination operate in the health system to understand how best to tackle the issue.
The Ockenden review noted that extra training was needed for GPs and anaesthetists, as well as midwives, to work toward better, inclusive care.
NHS England has stated it is committed to ensuring ‘all women receive high-quality care before, during and after their pregnancy’ and it has provided £6.8 million to help local health systems reduce inequalities. However, a report by Sands and Tommy’s notes that for every £1 spent on maternity care in the NHS, only 1p is spent on pregnancy research. The report notes that whilst research funding so far has focused on critical areas, other areas such as economic analysis and policy research have received less funding.
15-19 May 2023 is the first ever Black Baby Loss Awareness Week. BBLAW was co-founded by Tommy’s midwife, Alicia, to raise awareness of the support available for black families after pregnancy and baby loss. The Tommy’s website provides an overview of the events held during the week and links to further support.
As a response to Black Baby Loss Awareness Week, Tommy’s has launched a midwife video call service for black mothers.
Helen Hammond, senior associate specialising in maternity cases, comments: “I have been representing families whose babies have died or suffered harm because of the care they or their mother received around the time of birth for more than 10 years. Sadly, over this time I have seen the statistics play out and a good proportion of my clients have been, and continue to be, from black or ethnic minority backgrounds.
“One strong theme I hear from my clients is that they ask for help but are not heard and there is absolutely no justification for this. We must make sure that proper thought and research is given to the reasons for the disparity in outcomes and that this focus goes on to fuel real change, to make maternity care safer for black mothers and their babies.”
If you have been affected by any of these issues and would like some professional advice, our specialist gynaecology and maternal injury team is here to offer an informal discussion to explain what your options are. Please call 0800 328 9545, email firstname.lastname@example.org or complete our online assessment form.