Black women in the UK experience maternity discrimination and mixed care, according to a new report from Five X More

A new survey from campaigning organisation Five X More has found that Black women in the UK continue to experience discrimination and are receiving a mixed level of maternity care during the antenatal, labour, and postnatal period.

Studies, such as MBRRACE-UK’s annual Confidential Enquiry into Maternal Deaths, have consistently shown disparities between Black and white women’s maternal experiences and outcomes. However, the reasons for the differences remain unclear and under-researched.

Marian Knight, Professor of Maternal and Child Population Health at the University of Oxford, said:

“Inequalities in maternal death rates between Black women and White women in the UK have been documented for many years, and it is thanks to the work of Five X More and other advocates that tackling this disparity is now recognised as a priority. It is only by listening to women that we can understand the full impact of the care we are providing and identify ways to improve.”

The aim of Five X More’s survey was to better understand Black women’s experiences of UK maternity care and show that Black and Brown women are not, as has commonly been cited, “hard to reach”.

Key survey findings

Responses were gathered from more than 1300 women and birthing people around the UK who either identified as Black or of Black mixed heritage and had accessed NHS maternity services whilst pregnant between 2016 and 2021.

Five X More found that, overall, women reported that midwives were likely to discuss physical health status and safeguarding and social risk factors. However, there was a lack of information, advice and support given around mental health, rights, choices and social support. Additionally:

• For women who experienced miscarriage or pregnancy loss, 61% report that they were not offered any additional support to deal with the outcome of the pregnancy.

• Just over a third (36%) of respondents reported feeling dissatisfied with how concerns were addressed during labour.
• 43% percent reported their pain relief options were not explained to them and 52% of women who did not receive their choice of pain relief said there was no explanation as to why it was not given to them.
• While 78% with health concerns after birth those with concerns said they raised their concerns with a Health Care Professional, 36% of respondents said that they were not confident to ask for help on the postnatal ward.

Tinuke Awe, co-founder of Five X More, said:

“Despite the stark disparities in maternal outcomes, Black women’s voices and lived experiences have been notably absent from literature to date. The findings in this report highlight the urgent work needed to ensure that rapid improvements are made - because a positive birthing experience is deserved not just by some, but by all.”

Recommendations

In response to the data and first-hand accounts of Black and Brown women, Five X More has identified six key recommendations:

1.  An annual maternity survey targeted specifically at Black women
2.  Increased knowledge on identifying and diagnosing conditions that are specific to and disproportionately affect Black women
3.  Improve the quality of Ethnic coding in health records
4.  More community-based approaches must be used to improve maternal outcomes
5.  An improved system for women to submit their feedback and/ or complaints specifically for maternity
6.  Ensure that individuals involved in training health care professionals are aware and have an appreciation of the disparities in maternity outcomes.

Download the full report for more detail

More about Five X More

Five X More, co-founded by Clotilde Abe and Tinuke Awe, is dedicated to supporting mothers with its campaigning work and recommendations. It focuses on empowering Black women to make informed choices and advocate for themselves throughout their pregnancies and after childbirth. They are also committed to calling on those in power to change the outcomes for Black women.

Read Clotilde's guest blog: 'Services supporting maternal mental health must hear the voices of black and brown women'