Black women are five time more likely to die during childbirth than their white counterparts. The findings from the Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) report in 2018 by The National Perinatal Epidemiology Unit highlighted this stack inequality. This article will highlight the structural inequalities faced by Black women before childbirth and their maternal experience within the health care system. It will propose policy reforms to tackle these inequalities.
To reverse this reality of Black women’s maternal care, we need to tackle the social driver of this inequality. The intersection of poverty, race and gender means that Black women have been severely impacted by cuts to social security and public services. This has led to a dramatic fall in the standard of living of many Black women. These inequalities also mean they earn less, own less, and have more responsibility for unpaid care and domestic work. Black women especially face persistent structural inequalities in education, employment, health, and housing. A good financial position means a better quality of life, which translates to better health. There remains a statistically significant differences in the maternal mortality rates between women living in the most deprived areas and those living in the least deprived areas. This inequality means women leaving in deprived area are more prone to pre-existing health condition such as heart disease, which has been highlighted as a common medical cause of maternal deaths. This must be prevented. We need healthy young girls, teenagers and young women who will in turn become healthy pregnant women.
There must be significant investment in social infrastructure in Black communities. The health care services available for Black women before maternal care is paramount. Healthy mothers mean healthy babies and healthy babies become adults that are able to contribute beneficially to society. These services are vital to both the economy, wellbeing, and life chances of individuals. Black families are particularly impacted by the continuous cuts to benefits and public services. This has meant that lower quality of life and development of health conditions, which later impacts pregnancies.
Black mothers need support with the full experience of motherhood. From their first scan to the delivery, their experiences should be filled with the best care. However, this is not the experience of many mothers. Conscious and unconscious biases negatively impact Black women’s experience of the health care system. For example, the assumption that Black women have a higher pain threshold because they are strong Black women. These perceptions have an impact in how Black women access care and how they are perceived in the health care system. Therefore, there is a requirement to have a diverse workforce in our health care system. We need maternal health professionals with the cultural competency and sensitivity to deliver the best quality care for all their patients.