When Sonah Paton was pregnant with her first child, there was a point in her pregnancy where she didn’t feel quite right.
“My gut was telling me something was up, but as a Black woman I doubted my gut feeling would have the right credentials to access the right support.”
This feeling goes beyond superstition or paranoia though. Black women are dying at nearly four times the rate of white women during and after pregnancy, according to MBRRACE UK 2022.
Countless stories of Black women who have either died or experienced complications during pregnancy go back years.
Racism is a key word used to describe some of these cases, while this year, an investigation into the death of a 31-year-old Black pregnant woman at Liverpool Women’s Hospital found that ‘cultural bias and stereotyping’ delayed the care she was given.
Maternity and Newborn Safety Investigations found that the woman was in “acute pain” and vital observations were missed as she was dismissed as being “difficult”.
So, Sonah’s gut feeling is one that’s based on the experiences of the many Black women who have lost their lives during such a vulnerable time, due to arguably preventable causes.
“It turns out that I had gone into labour at 28 weeks. That’s early, that’s three months early,” she adds.
A baby being born preterm is another factor that disproportionately affects Black women, something Sonah wasn’t aware of.
By the time Sonah was pregnant again, this time with her third child, she decided to have a home birth because it was tiring for her to hide parts of her identity to avoid triggering bias in staff.
She also decided that it was time to take action and formed a group called Black Mothers Matter with her friends, Aisha Davies and Yomi Oluwatudimu – both expectant first-time mothers.
Black Mothers Matter is a community group for Black mums and pregnant women, it offers resources, mental health services and is also in partnership with healthcare professionals in the NHS to deliver anti-racism programmes.
“The minimum we need is a target and strategy to end disparities in maternal deaths. I think there needs to be a real acknowledgement that this is an issue of race and racism. It’s not to do with poverty or any other factor,” Sonah shares.
“We need to be braver and more honest in the conversations we’re having about race and racism and overall, government and society need to develop racial literacy skills, so we’re able to have honest, brave and thoughtful conversations about racism.”
What part have institutions played so far?
The Government has acknowledged that it must do more, but last year rejected recommendations by the Women and Equalities Committee to introduce a target to end disparities in maternal deaths and to increase the maternity services’ annual budget.
The Government did introduce a Maternity Disparities Taskforce in 2022.
Originally it was set up to meet every two months and to identify ways to improve outcomes for ethnic minority communities, but it hasn’t met since April last year.
The NHS has made some progress. Alongside partnering with groups such as Black Mothers Matter to help improve outcomes for Black pregnant women, they also published a three-year delivery plan for maternity and neonatal services in 2023.
This plan includes goals to improve equity for mothers and babies, such as collecting and monitoring local data and feedback from mothers to improve care and continuity of carer, which means having the same midwife throughout the maternity journey.
It’s a start, but what about the Black women who don’t have three years? What about those who are having children today, tomorrow and next week?
“There’s always discrepancies in the care that they get”
Kike AJ is a Black mum and content creator who recently had her first baby.
She’s documented her pregnancy journey extensively, both through social media and a personal scrapbook, including her experience at a Black antenatal classes.
Both her and her partner made it a priority to be vocal in what they wanted and advocated for the type of care she wanted to receive:
“Our issues and barriers [as Black women] are different to women of other ethnicities. We already know that Black women are four times more likely to experience not so great things in labour and delivery and I really wanted to be in a space where that was pushed at the forefront and we were tackling those issues head on.
“I also believe that knowledge is power, so going to these classes and them recognising that I’m a Black woman and my experience is unique… they gave me knowledge in a specific way that catered to that difference.”
One of the antenatal classes Kike went to is run by midwife Elizabeth Idowu, otherwise known as Mamadinya. She’s best known for her viral videos giving advice to pregnant women.
Her classes have a heavy emphasis on being exclusively safe spaces for Black pregnant women, so much so that no one else – whether it’s a partner, friend or family member – are allowed to join.
@mamadinya Joys of having your own business is you can unapologetically be yourself 😂😘 Next class we are playing giggs 😘 Head to mamasclasses.com to book your class! For online classes or 1:1 classes email [email protected] #fyp #mamadinya #antenatalclass #firsttimemom #mamasclasses #midwife #antenatalclasslondon #studentmidwife
Elizabeth says her motivation for the content and work she does stems from an understanding that the healthcare system doesn’t necessarily cater for Black women.
“Antenatal classes are very important for Black women,” she adds.
“There’s always, and probably always will be, discrepancies in the care that they get, compared to other women. It’s important for them to know that they’re in charge of their own bodies, how to give consent, how to advocate for themselves.”
How can this issue be resolved?
Obstetrics and Gynaecology Consultant, Dr Karen Joash is very vocal about maternal equity. She acknowledges that the way care is delivered within the system has its issues, largely stemming from education and training.
Education and training don’t typically use Black ‘bodies’ and the differences that come with it. White mannequins are typically used during training and education on urgent patient care.
“Of course that’s going to affect our outcomes because we’re not going to assess people in the same way that we need to. Our systems need to be overhauled and changed,” she says.
The aim is that the disparity in maternal deaths diminishes sooner rather than later. For some that means reworking the healthcare system entirely, but for now, Black women have no choice but to be the frontrunners of change.
