This story is part of Black Ballad’s takeover of HuffPost UK, a week-long series by Black women on parenting, family, and our post-Covid future.
Black women have revealed the shocking racism they faced in the UK’s healthcare system during pregnancy and childbirth, in a landmark study that sheds light on the country’s damning death rate for expectant Black mothers.
The survey, carried out by lifestyle publication Black Ballad, with more than 2,500 respondents, uncovered stories of substandard care, discrimination and microaggressions that marred the experiences of many pregnant women. From the wrong dosage of medications being administered to jibes being made from healthcare practitioners about their ability to speak English, Black women have revealed deeply harrowing experiences of being abused and placed at risk during pregnancy.
Not only did it leave expectant mothers hurt and humiliated but many reported feeling scared as health concerns went undetected and they were rendered voiceless while facing an increased risk of death during a time when they were most vulnerable.
Underpinning these experiences is the disgraceful statistic that Black women are five times more likely than white women to die in pregnancy and childbirth in the UK and Ireland.
One woman, Patricia, was diagnosed with postnatal ovarian cancer – a condition that healthcare practitioners had failed to detect during her pregnancy, she told Black Ballad, despite numerous complaints of pain.
Another, Melissa, was diagnosed with early stage ovarian cancer after doctors failed to take her concerns seriously. “Because I was young, I was told to wait for my body to settle down,” she said.
Speaking to HuffPost UK, 43-year-old mother of two Natalie Lue explained: “As Black women, we have been raised to believe we have to do the whole ‘strong Black woman’ thing. What’s interesting is in society, and in the medical profession, that’s reinforced. It’s like we have to be literally dying on you before you say: ‘Let me take a closer look at you and see how you’re doing.’”
Her words are echoed by other mothers who shared their stories with Black Ballad – which is guest editing HuffPost UK this week with a series on Black parenting, family and healthcare.
One wrote: “In the throes of my labour I was made to walk to my delivery room even though I was holding on to the wall to stay on my feet. Prior to my labour, though, I watched other non-Black women being wheeled in wheelchairs to their delivery room.” After delivery, made to walk again, she passed out and only then was she given assistance.
“Fear stopped me from speaking out; it was my first appointment and I just wanted the best for me and my daughter.”
Racist microaggressions were another problem spoken about by respondents.
Tobi Oredein, Black Ballad’s co-founder, recalled one such experience during her first prenatal appointment a year ago. The midwife referred to her husband, Bola Awoniyi, as her “baby daddy”.
“It felt like a very racially charged stereotype to say to a young Black couple,” Oredein, 30, said. “It made me feel really small.
“I didn’t challenge her. Fear stopped me from speaking out; it was my first appointment and I just wanted the best for me and my daughter. I didn’t want to be marked as a problem in case it backfired on the care I’d receive later on in the pregnancy.”
Another respondent was 19 when her first pregnancy ended with a miscarriage. “The nurse told me after the scan: ‘Yeah, the baby is gone so you can go and enjoy your life now,’” she said. “I was given no advice or consolation.”
One woman, Charlene, told Black Ballad that from the outset her midwife spoke to her as though she were an “inmate” at a prison and denied her the right to have a say in her own birth plan.
She said: “During both my previous pregnancies I noticed that healthcare professionals often assume that, as a Black female, you are a single parent based on looking at you. They appear to find it even more surprising to find out you’re married.”
“My midwife did not listen to me as though I was the pregnant woman. She handled me as though I was a child or an inmate at a prison.”
She added: “During my last pregnancy I felt that I was given less discussion or choice [than] many of the white expectant mothers I met during my journey. My midwife did not listen to me as though I was the pregnant woman. She handled me as though I was a child or an inmate at a prison where she completely ignored any of my requests regarding my birth plan although I’d had the experience of being pregnant and giving birth the year before.
“The midwife always asked me questions and made notes. However, each time I would check my maternity records and her notes, I would find she made a habit of taking anything I said out of context and made me appear to be unstable to anyone reading my paperwork.”
The same midwife, upon meeting Charlene’s mother, proceeded to question her about how long she had lived in the country, where Charlene’s father was, what job she does and whether she owns her home – all completely irrelevant to her pregnancy and rooted in racist stereotypes.
Black mothers living with disabilities face an even more heightened risk during pregnancy. Some of the women surveyed by Black Ballad reported developing undiagnosed adenomyosis, pre-eclampsia and fibroids – conditions that are prevalent among Black women – and having sickle cell crises, which again disproportionately affect Black people.
All Black Lives UK is a pressure group that has been lobbying the government to bring about an end to race disparity in healthcare. Spokesperson Aima, 18, who preferred not to give her surname, said Black pregnant women are dying in disproportionate numbers because of racism, plain and simple.
“Medical professionals have been told that Black people, especially Black women, are stronger than white people,” she told HuffPost UK.
“There’s a stereotype that Black women are stronger and can handle everything, so Black women aren’t treated the same as their white counterparts. In the medical field there’s obviously racism that hasn’t been addressed and needs to be.
“This disparity has also evidenced through the Covid-19 report that we weren’t given straight away, which showed that Black people faced a heightened risk of contracting the virus. Racism, systemic inequalities, is at the heart of this issue.
“I’ve always had worries about having children because of the statistic that I face a heightened risk as a Black woman. It’s terrifying to think that I could be in so much pain and medical practitioners will either think I’m overreacting or I’m strong enough, so I can handle it. It’s hurtful. The medical industry has a such a problem with racial discrimination and that isn’t being talked about openly where it should be.”
Natalie Lue added: “There’s something wrong with the system here. It’s like Black women are not allowed to be ill; we’re inconveniencing you by using the medical system that we bloody well contribute to.”
Born and raised in Dublin, she’d always received a high quality of healthcare. But her experience deteriorated significantly when she moved to London and had two children between 2007 and 2009.
During her first pregnancy, Lue ended up being induced at 11 days overdue. After spending 36 hours in agonising labour that was not progressing due to the angle of the baby, she overheard a white midwife saying to her colleagues that she was highly concerned and an emergency Caesarian section should have been conducted hours earlier.
Another midwife dismissively replied: “Leave her.”
“If a white woman gets upset, it’s like: 'There, there – let me get you a cup of tea and a biscuit.' Black women don’t get sympathy.”
After the operation, a consultant confirmed to Lue that her condition should have been picked up earlier. At this point, Lue reported the conversation she’d overheard between the midwives and received an apology.
“I don’t think I’ll ever get over the humiliation – I felt unsafe and I felt humiliated,” she told HuffPost UK. “Obviously they didn’t know that I’d overheard the conversation and I thought: ‘Wow – is this how we’re spoken about?’”
During her second pregnancy, a white nurse told her she didn’t have a high enough pain threshold. She was pressured to do a vaginal birth despite underlying health conditions.
Finally, she was advised at the eleventh hour that this would risk both her and her baby’s lives, and she should have had a C-section sooner.
“It’s like we’re not seen as human, worthy of respect,” she said. “If I get upset, I’m being difficult.”
She added: “If a white woman gets upset, it’s like: ‘There, there – let me get you a cup of tea and a biscuit.’ Black women don’t get sympathy.
“White women also die in childbirth and have problems with midwives – but we have it at a far higher rate. I know the NHS is stretched and I have a great deal of respect for it. Some of these hiccups and problems come from that.
“But when it comes to Black women it comes down to lack of respect and bias.”
Lue also stressed that a number of racist microaggressions came from health workers with Asian backgrounds, as well as white people.
“The BAME label doesn’t mean that every ethnic minority person is treated the same,” she said.
In 2019, a group of Black women launched the FiveXMore campaign in response to the MBRRACE report that uncovered the original disparity in death rates. The founder, Tinuke Awe, 28, set up a petition to the government calling for it to address the problem, which amassed over 180,000 signatures. It is still awaiting debate.
“The FiveXMore campaign wasn’t very well received at all until the Black Lives Matter movement happened. Everybody wanted to get involved and speak to us about it. A lot of people didn’t realise that this was a problem in the UK – many thought it was just the US,” Awe, a mother-of-two, told HuffPost UK.
“I’m so happy that we’ve finally been able to raise awareness and get the message out there but it’s a shame it took the televised murder of George Floyd for more people to start having this conversation.
“Since then, people have been reaching out with their stories, women have said ‘thank you for speaking up’ because either they thought it was normal to receive such poor care or they were so grateful that they made it out alive with their baby, so resolved not to even speak about it. On the flipside, there’s a lot of midwives and doctors having really uncomfortable conversations about how and why this is happening.”
Racism is deeply entrenched in medicine, Awe said, and the Eurocentric nature of the profession has historically been at the expense of Black women’s lives.
For example, Dr James Marion Sims – who is widely regarded as the “father of modern gynaecology” – performed experimental surgeries on Black female slaves without anesthesia between 1845 and 1849 as he perfected his method of fistula operations.
“The reason for the Black maternal mortality rate is multifaceted and there are different layers,” Awe added. “There’s all sorts of reasons such as racism, microaggressions, doctors not believing Black women and their pain; plus this disparity isn’t taught in medicine – we’ve spoken to doctors and midwives who don’t even know that Black women are five times more likely to die from pregnancy complications. If there is no awareness in the first place, and people don’t know about it, then what can be done?”
Statistics released during Covid-19 highlighted that 55% of pregnant women admitted to hospital with the virus were from Black, Asian or other ethnic minority backgrounds.
Pregnant Then Screwed, an organisation that advocates for working mothers’ rights, launched a petition calling for BAME pregnant women to be shielded. It has so far garnered more than 3,000 signatures.
It found in a recent survey that 25% of pregnant NHS workers are risking their lives by working in direct contact with patients who could have Covid-19, while 24% of pregnant NHS workers feel “unsafe” – rising to 31% for those who are BAME.
The risk is laid bare by tragic cases like that of Mary Agyeiwaa Agyapong – a Black nurse who contracted coronavirus and died on April 12 shortly after delivering her baby son.
Meanwhile, a 2019 study conducted by Queen Mary, University of London, indicates that Black women are 1.5 times more likely to experience a stillbirth than white women.
“We have a duty to ensure that no woman or her family suffers unnecessarily and that we address racial inequality, where it exists.”
On July 15 the Royal College of Obstetrics and Gynaecology set up a Race Equality Taskforce to get to the bottom of why there are racial disparities in women’s healthcare and to better understand the racism that workers experience – headed up by Dr Christine Ekechi, consultant obstetrician and gynaecologist at Imperial Healthcare.
“It is easy to forget that an individual woman lies behind every shocking statistic; a woman who has died or suffered a poor health outcome, sometimes along with her baby,” Dr Ekechi told HuffPost UK.
“Whilst the majority of outcomes for pregnant women and their babies are positive, there is a stark truth that Black, Asian and minority ethnic women have a greater chance of suffering a poorer experience or health outcome when compared to white women. This is completely unacceptable,” she said.
Dr Ekechi added that healthcare providers had a duty to “address racial inequality, where it exists”.
In response to the Five X More petition, the government said its NHS long-term plan would reduce health inequalities, and that it would aim for 75% of BAME women to get “continuity of care” – that is, the same midwife caring for them throughout pregnancy – by 2024.
“They referenced ‘BAME’ which is quite damaging because it conflates different statistics,” said Awe. “Plus what happens between now and 2024? Their response is not immediate enough.”
A government spokesperson told HuffPost UK: “This is a complex and concerning issue. The NHS has already taken action on the ground, and we are examining what more can be done. Later this summer the Minister for Equalities will be co-hosting a roundtable on this vital issue with academics and key health professionals, to identify the actions needed to protect Black, Asian and minority ethnic mothers.”
Shadow women and equalities secretary Marsha de Cordova told HuffPost UK: “Inequality and injustice define everyone’s long-term health, wealth and working conditions. We have known for some time that Black and south Asian women in the UK are disproportionately more likely to die during childbirth, or in the first year of their child’s life, and it is high time that more research is undertaken to really understand why this is the case and what can be done to address it.
“Once this research is complete, ministers need to urgently address maternal health inequalities with a clear plan [...] to make giving birth and being a new mother in the UK as safe for Black and south Asian women as it is for anyone else.”
This article was commissioned for HuffPost UK by Black Ballad, the lifestyle platform that tells stories of human experience through the eyes of Black British women and elevates their voices. If you would like to read more, become a Black Ballad member to get unlimited access to content, events and discounts, and to connect to its community of like-minded women.